| NPI | 1588805444 |
|---|---|
| Doing Business As | SOUTH LAKE OPTICAL |
| Entity Type | Organization |
| Authorized Contact | GRAY ROBERT SMITH Pres 352-243-5349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: FL OPC 3661) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2012-03-06 |