| Eye Works Of Land O' Lakes | |
|
21517 Village Lakes Shopping Ctr Dr, Land O Lakes, FL 34639-5101 | |
| (813) 949-1982 | |
| (813) 948-0351 |
| Full Name | Eye Works Of Land O' Lakes |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 21517 Village Lakes Shopping Ctr Dr, Land O Lakes, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790015303 | NPI | - | NPPES |
| 621017100 | Medicaid | FL | |
| 621016300 | Medicaid | FL | |
| 084928600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OPC001159 (Florida) | Secondary |
| 152W00000X | Optometrist | OPC003906 (Florida) | Secondary |
| 152W00000X | Optometrist | OPC003907 (Florida) | Primary |
| Provider Name | Luc E Kanicky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043275175 PECOS PAC ID: 2365349743 Enrollment ID: I20050630000586 |
| Provider Name | Jee M Kanicky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245296599 PECOS PAC ID: 8729985296 Enrollment ID: I20050630000709 |
| Provider Name | Riz J Khan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194735837 PECOS PAC ID: 5597820803 Enrollment ID: I20090220000441 |
| Provider Name | Mark Humphries |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467550731 PECOS PAC ID: 8022148055 Enrollment ID: I20100617000365 |
| Mailing Address | Practice Location Address |
|---|---|
| Eye Works Of Land O' Lakes 3249 Stonegate Falls Dr, Land O Lakes, FL 34638-6195 Ph: (813) 495-8883 | Eye Works Of Land O' Lakes 21517 Village Lakes Shopping Ctr Dr, Land O Lakes, FL 34639-5101 Ph: (813) 949-1982 |
Dr. Riz Juan Khan, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 21517 Village Lakes Shopping Ctr Dr, Land O Lakes, FL 34639 Phone: 813-949-0421 Fax: 813-949-0351 | |
Dr. Jee Me Kanicky, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 21517 Village Lakes Shopping Ctr Dr, Land O Lakes, FL 34639 Phone: 813-949-0421 Fax: 813-949-0351 | |
Chelsey Lyn Shepos, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2100 Via Bella Blvd Ste 105, Land O Lakes, FL 34639 Phone: 813-284-2300 Fax: 813-979-1600 | |
Mr. Mark Humphries Jr., OD Optometrist Medicare: Medicare Enrolled Practice Location: 21611 Village Lakes Shopping Center, Land O Lakes, FL 34639 Phone: 813-949-1982 Fax: 813-949-0422 | |
Mobile Eye Care Services Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 5488 Land O Lakes Blvd, Land O Lakes, FL 34639 Phone: 813-312-1174 | |
Myeyedr. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 21517 Village Lakes Shopping Ctr Dr, Land O Lakes, FL 34639 Phone: 813-949-0421 Fax: 813-949-0351 |