| NPI | 1912151606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ERIK FALDEN Manager 954-682-4253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 4219) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: FL OPC 4176) |
| Enumeration Date | 2008-11-08 |
| Last Update Date | 2009-09-15 |