| NPI | 1013027317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADONNA COFFMAN Administartor 561-227-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-04-09 |