Provider Demographics
NPI:1447365085
Name:HAINES, VICTORIA V (OD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:V
Last Name:HAINES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9375 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-4418
Mailing Address - Country:US
Mailing Address - Phone:727-541-4469
Mailing Address - Fax:727-546-9661
Practice Address - Street 1:9375 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-4418
Practice Address - Country:US
Practice Address - Phone:727-541-4469
Practice Address - Fax:727-546-9661
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2656152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0002644OtherOPTOMETRIST PRESCRIBER #
FLOPC2656OtherCERTIFIED OPTOMETRIST
FLOPC2656OtherCERTIFIED OPTOMETRIST
FL20579Medicare ID - Type Unspecified