| NPI | 1962674606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE GOLDEN O PT Ometric Physician 941-342-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: FL OPC2764) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2010-05-25 |