Provider Type Icon

ST. JUDE MEDICAL & AESTHETIC CARE CENTER LLC NPI 1518260090


NPI Information

NPI: 1518260090
Provider Name: ST. JUDE MEDICAL & AESTHETIC CARE CENTER, LLC

Doing Business As: ST. JUDE MEDICAL CENTER & AESTHETIC CARE

Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 10D2025474

Address:
131 N MOON AVE
SUITES 3 & 4
BRANDON, FL
ZIP 33510
Phone: (813) 315-9898
Get Directions

ST. JUDE MEDICAL & AESTHETIC CARE CENTER, LLC is an ophthalmology in Brandon, FL. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. ST. JUDE MEDICAL & AESTHETIC CARE CENTER, LLC NPI is 1518260090. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As St. Jude Medical Center & Aesthetic Care.

The provider's business location address is:

131 N MOON AVE
SUITES 3 & 4
BRANDON, FL
ZIP 33510-418
Phone: (813) 315-9898
Fax: (813) 438-5967

The provider's authorized official is Godwin Stanley Okoye .
The authorized official title is Medical Director and has the following contact phone number (813) 330-6613.

The CLIA number assigned to this NPI record is 10D2025474 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/6/2010 and was last updated on 10/8/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12083P0901XPreventive MedicinePublic Health & General Preventive MedicineNo
2132700000XDietary ManagerNo
3146D00000XPersonal Emergency Response AttendantME107980FLORIDANo
4207QA0401XFamily MedicineAddiction MedicineME107980FLORIDANo
5208D00000XGeneral PracticeME107980FLORIDANo
6208U00000XClinical PharmacologyME107980FLORIDANo
7207W00000XOphthalmologyME107980FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.