Eye Works of Land O' Lakes

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC003907 Issued in FL

Legal business name

EYE WORKS OF LAND O' LAKES

Practice address

21517 Village Lakes Shopping Ctr Dr
Land O Lakes, FL 34639-5101

Phone

(813) 949-1982

Fax

(813) 948-0351

NPI assigned

Jan 4, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jee Me Kanicky, O.D.

Title

Officer

Phone

(813) 949-1982

Specialties & licenses 3

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1790015303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 STONEGATE FALLS DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346386195",
            "telephone_number": "813-495-8883",
            "fax_number": "813-948-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21517 VILLAGE LAKES SHOPPING CTR DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346395101",
            "telephone_number": "813-949-1982",
            "fax_number": "813-948-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE WORKS OF LAND O' LAKES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "KANICKY",
        "authorized_official_first_name": "JEE",
        "authorized_official_middle_name": "ME",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "813-949-1982",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001159",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC003906",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC003907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621017100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621016300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084928600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Land O' Lakes, FL
• Providers in Land O' Lakes, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.