| NPI | 1639632763 |
|---|---|
| Other Name | MS. |
| Entity Type | Organization |
| Authorized Contact | RAVEN SHENETTE MAYES Doctor Of Optometry 352-792-8069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2021-04-16 |