| NPI | 1649317082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA CORDOVA Owner 954-432-1532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC2957) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: FL OPC02957) |
| 152WS0006X Optometrist Sports Vision (Licence: FL OPC2957) | |
| 152WX0102X Optometrist Occupational Vision (Licence: FL OPC02957) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |