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Contact Information

CARLA I BOURNE, MD
13127 USF MAGNOLIA DR
MDC21
TAMPA, FL33612
 Phone: 813-974-2064
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for CARLA I BOURNE · (Female)

NPI # 1073707840
Status Active
Credentials MD
Entity Individual
Enumeration date 09/05/2007
Last updated 01/07/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME107148
  • FL Medicaid 002245800
  • FL Other 149KG BLUE CROSS BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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