| NPI | 1386821379 |
|---|---|
| Doing Business As | VISION SOURCE FORT LAUDERDALE |
| Entity Type | Organization |
| Authorized Contact | BRANDON WILLIAM CORNISH CEO 954-522-3918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4217) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2012-10-30 |