Bayside Family Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 4418 Issued in FL

Legal business name

BAYSIDE FAMILY EYECARE

Practice address

6911 Pistol Range Rd Ste 103B
Tampa, FL 33635-6335

Phone

(813) 925-3393

Fax

(813) 925-3394

NPI assigned

Aug 10, 2009

Organization subpart

No

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

Authorized official

Name

David Michael Archibald, O.D.

Title

Owner

Phone

(813) 925-3393

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jee Me Kanicky, O.D.

  • Optometrist
  • Land O Lakes, FL
  • NPI 1245296599
  NPD (past)
• Luc Emmanuel Kanicky, O.D.

  • Low Vision Rehabilitation Optometrist
  • Tampa, FL
  • NPI 1043275175
  NPD (past)
• Carli Ruckman, O.D.

  • Optometrist
  • Winter Haven, FL
  • NPI 1891075578
  NPD (past)

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249862400000",
    "number": "1942432935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 PISTOL RANGE RD STE 103B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336356335",
            "telephone_number": "813-925-3393",
            "fax_number": "813-925-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 PISTOL RANGE RD STE 103B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336356335",
            "telephone_number": "813-925-3393",
            "fax_number": "813-925-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A",
        "authorized_official_last_name": "ARCHIBALD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-925-3393",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bayshore Orthodontics PLLC
• Bayshore Pediatric Dentistry and Orthodontics PLLC
• Bayshore Podiatry Center
• Bayshore Podiatry Center Inc
• Bayside Breeze Therapy LLC
• Bayside Family Healthcare Clinic
• Bayside Infusion Services, LLC
• Bayside Injury Center LLC
• Bayside Medical Group
• Bayside Medical Group of Florida

• Optometrist in Tampa, FL
• Providers in Tampa, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.