| NPI | 1679757918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN HOWARD SIEGEL Optometrist 772-335-5006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC1190) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL FL1190) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2008-10-29 |