| NPI | 1609494566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSA TORRES Credentialing Specialist 863-294-3504 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |