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NPI Code Detail

MEDICARE: DR. WILLIAM ALBERT MISNER O.D.

MEDICARE: DR. WILLIAM ALBERT MISNER O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPC2199FL

General Provider Information

NPI Number : 1225161094
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM ALBERT MISNER O.D.
Provider Business Mailing Address
First Line : 1110 BAYWOOD CT
Second Line :
City : MALABAR
State : FL
Zip : 32950-3359
Country : US
Telephone Number : 321-984-3494
Fax Number :
Provider Business Practice Location Address
First Line : 1040 MALABAR RD SE
Second Line :
City : PALM BAY
State : FL
Zip : 32907-3251
Country : US
Telephone Number : 321-984-3494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 07/08/2007

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