Active NPI
Lighthouse of Pinellas Inc
- Low Vision Rehabilitation Optometrist
- Largo, FL
National Provider Identifier
1801858071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Low Vision Rehabilitation Optometrist
- Legal business name
- LIGHTHOUSE OF PINELLAS INC
- Practice address
- 6925 112TH Cir
Largo, FL 33773-5200 - Phone
- (727) 544-4433
- Fax
- (727) 544-5511
- NPI assigned
- Apr 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Daniel T Mann
- Title
- President/Ceo
- Phone
- (727) 544-4433
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Low Vision Rehabilitation Optometrist | 152WL0500X | Primary |
Addresses
Primary practice location
6925 112TH Cir
Largo, FL 33773-5200
Mailing address
6925 112TH Cir N
Largo, FL 33773-5520
Phone (727) 544-4433
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 880145200 | Medicaid | FL | |
| 880147900 | Medicaid | FL | |
| 882356100 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
6925 112th Cir
Ste 101
Largo, FL 33773
6925 112th Cir
Ste 103
Largo, FL 33773
Phone (727) 544-4433
6925 112th Cir
Largo, FL 33773
Phone (727) 544-4433
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Speech-Language Pathologist
- Largo, FL
- NPI 1083714745
-
- Optometrist
- St Petersburg, FL
- NPI 1629004999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1465430400000",
"number": "1801858071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6925 112TH CIR N",
"city": "LARGO",
"state": "FL",
"postal_code": "337735520",
"telephone_number": "727-544-4433",
"fax_number": "727-544-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6925 112TH CIR",
"city": "LARGO",
"state": "FL",
"postal_code": "337735200",
"telephone_number": "727-544-4433",
"fax_number": "727-544-5511"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIGHTHOUSE OF PINELLAS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-04",
"last_updated": "2016-06-09",
"status": "A",
"authorized_official_last_name": "MANN",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "727-544-4433",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "152WL0500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "880145200",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "880147900",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "882356100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.