Provider Demographics
NPI:1144287319
Name:SINCLAIR & CAMP OD PA
Entity type:Organization
Organization Name:SINCLAIR & CAMP OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-752-2020
Mailing Address - Street 1:9122 58TH DR E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-9187
Mailing Address - Country:US
Mailing Address - Phone:941-752-2020
Mailing Address - Fax:941-752-2040
Practice Address - Street 1:9122 58TH DR E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-9187
Practice Address - Country:US
Practice Address - Phone:941-752-2020
Practice Address - Fax:941-752-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-29
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP02661152WC0802X, 152WP0200X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620040101Medicaid
FL620040101Medicaid
FL24549AMedicare ID - Type Unspecified
FL0758320002Medicare NSC