| NPI | 1154596948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE P FULLER Optometrist Sole Provider 407-846-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC797) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |