Organization Active NPI

Value Vision of Tampa Bay Inc

  • Optometrist
  • Brandon, FL
National Provider Identifier
1720250152
Registry record updated Apr 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3737 Issued in FL
Legal business name
VALUE VISION OF TAMPA BAY INC
Practice address
1180 Nikki View Dr
Brandon, FL 33511-4868
Phone
(813) 651-1400
Fax
(813) 651-0697
NPI assigned
Mar 26, 2008
Last updated
Apr 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Laura VizzariNPI 1013907914
Title
President
Phone
(813) 651-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3737 FL Primary

Addresses

Primary practice location

1180 Nikki View Dr
Brandon, FL 33511-4868

Mailing address

1180 Nikki View Dr
Brandon, FL 33511-4868
Phone (813) 651-1400

Other identifiers 1

IdentifierTypeStateIssuer
620792800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080906000154 FL Part B Supplier - Clinic/Group Practice 5890861363 Receives reassigned benefits from 3 practitioners
Practice locations: Brandon, FL

National Provider Directory

National Provider Directory

Locations

1180 Nikki View Dr
Brandon, FL 33511
Phone (813) 651-1400

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238716800000",
    "number": "1720250152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 NIKKI VIEW DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114868",
            "telephone_number": "813-651-1400",
            "fax_number": "813-651-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 NIKKI VIEW DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114868",
            "telephone_number": "813-651-1400",
            "fax_number": "813-651-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALUE VISION OF TAMPA BAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2009-04-03",
        "status": "A",
        "authorized_official_last_name": "VIZZARI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-651-1400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620792800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.