| NPI | 1356382725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JOSEPH LAQUIS Owner 239-947-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME82974) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2016-01-26 |