Provider Demographics
NPI:1992731772
Name:KEATS, CHRISTOPHER KUECHLE (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KUECHLE
Last Name:KEATS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2518 N MCMULLEN BOOTH RD
Mailing Address - Street 2:STE C
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-4156
Mailing Address - Country:US
Mailing Address - Phone:727-725-5558
Mailing Address - Fax:727-724-3966
Practice Address - Street 1:2518 N MCMULLEN BOOTH RD
Practice Address - Street 2:STE C
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-4156
Practice Address - Country:US
Practice Address - Phone:727-725-5558
Practice Address - Fax:727-724-3966
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3546152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU79696Medicare UPIN
FLE5131ZMedicare PIN