| NPI | 1396042834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIIP ROSS SIDRAN Doctor President 305-252-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC804) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2011-02-18 |