| NPI | 1598943508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA SUIVSKI Administrative Supervisor 772-286-9233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC2457) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2008-04-20 |