| NPI | 1881047850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE QUESADA MOORE Owner 850-769-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: FL OPC5212) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC5212) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |