| NPI | 1871056804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET O HIDALGO Owner 813-373-5873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-04-08 |