Healthcare Provider Details

I. General information

NPI: 1841662269
Provider Name (Legal Business Name): PAUL FLOWERS ABO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SALEEMAH ALI OPTICIAN

II. Dates (important events)

Enumeration Date: 10/25/2015
Last Update Date: 10/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 N UNION ST SUIT #119
WILMINGTON DE
19805-3031
US

IV. Provider business mailing address

717 N UNION ST SUIT #119
WILMINGTON DE
19805-3031
US

V. Phone/Fax

Practice location:
  • Phone: 302-256-3239
  • Fax:
Mailing address:
  • Phone: 302-256-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: