Tampa Bay Optometric Group PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TAMPA BAY OPTOMETRIC GROUP PA

Practice address

2143 Tyrone Blvd N
St Petersburg, FL 33710-4023

Phone

(727) 361-0431

Fax

(727) 344-7952

NPI assigned

Feb 20, 2006

Last updated

Oct 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Charles Engel

Title

Director of Administration

Phone

(727) 361-0431

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1992770473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40510",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337430510",
            "telephone_number": "727-361-0431",
            "fax_number": "727-344-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104023",
            "telephone_number": "727-361-0431",
            "fax_number": "727-344-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA BAY OPTOMETRIC GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "ENGEL",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "727-361-0431",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.