Sieboldt, Kent M
Sieboldt, Kent M is an sole proprietor health care provider with primary practice located at 324 E Bloomingdale Ave , Brandon FL 33511-8155. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Sieboldt, Kent M can be contacted via phone (813) 685-2646.Contact Information
Primary practice address
324 E Bloomingdale Ave
Brandon FL 33511-8155
Phone: (813) 685-2646
Fax: (813) 681-6821
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2120 | Florida |
Profile Details
| NPI number | 1295733137 |
|---|---|
| LBN Legal business name | Sieboldt, Kent M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2005 |
| Last updated | Feb 17th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295733137 | NPPES |
| Florida | MEDICAID | 086169300 |
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