Provider Demographics
NPI:1063554533
Name:MCGHEE, TRUMAN (OD)
Entity type:Individual
Prefix:DR
First Name:TRUMAN
Middle Name:
Last Name:MCGHEE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17854 LEE AVE
Mailing Address - Street 2:#202
Mailing Address - City:REDINGTON SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33708-1149
Mailing Address - Country:US
Mailing Address - Phone:727-393-7671
Mailing Address - Fax:
Practice Address - Street 1:7165 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-5934
Practice Address - Country:US
Practice Address - Phone:727-392-0906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 896152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19324Medicare ID - Type Unspecified
FLT83966Medicare UPIN