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1306863105
KARL DAVID JOHANNESSEN
MELBOURNE, FL
NPI
1306863105
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: FL OPC 2589)
Enumeration Date
2006-07-16
Last Update Date
2007-07-08
Business Address
Dr. KARL DAVID JOHANNESSEN OD
6300 N WICKHAM RD UNIT 123
MELBOURNE, FL 32940-2028
Phone number: 321-751-7270
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Mailing Address
Dr. KARL DAVID JOHANNESSEN OD
PO BOX 120759
MELBOURNE, FL 32912-0759
Phone number: 321-298-7339
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