| NPI | 1790721652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE LAURETTA SEIDE-JUSTIN President 407-292-9812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC003955) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2011-06-22 |