Humphries, Mark

Humphries, Mark is an sole proprietor health care provider with primary practice located at 21611 Village Lakes Shopping Center , Land O Lakes FL 34639-5102. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Humphries, Mark can be contacted via phone (813) 949-1982.

Contact Information

Primary practice address
21611 Village Lakes Shopping Center Land O Lakes FL 34639-5102
Phone: (813) 949-1982
Fax: (813) 949-0422
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC001159 Florida
Eye and Vision Services Providers / Optometrist 152W00000X 776 Louisiana
Eye and Vision Services Providers / Optometrist 152W00000X 674 Mississippi

Profile Details

NPI number 1467550731
LBN Legal business name Humphries, Mark
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2006
Last updated Aug 22nd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1467550731 NPPES
Florida Other 38918 DAVIS
Florida MEDICAID 084928600 DAVIS
Florida Other 19161A DAVIS
Florida Other 101718 DAVIS

Popular Providers