| NPI | 1598517575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUPRIYA KRISHNAN Owner 813-484-9908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202D00000X |
| Additional Taxonomies | 152WV0400X Optometrist Vision Therapy |
| 2083X0100X Preventive Medicine Occupational Medicine | |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2024-04-03 |