| NPI | 1710057054 |
|---|---|
| Doing Business As | BREVARD VISION CARE |
| Entity Type | Organization |
| Authorized Contact | RITA E. JIMENEZ Practice Manager 321-725-4755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC1857) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC0891) |
| 152W00000X Optometrist (Licence: FL OPC2189) | |
| 152W00000X Optometrist (Licence: FL OPC2747) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: FL OPC4006) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2008-02-13 |