| NPI | 1023293123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY L PETRUZZELLA Office Manager 386-445-1385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 3472) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-09-15 |