Healthcare Provider Details

I. General information

NPI: 1841606472
Provider Name (Legal Business Name): ADRIAN AL-DAMARI O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13275 W COLONIAL DR
WINTER GARDEN FL
34787-3984
US

IV. Provider business mailing address

110 S WOODLAND ST
WINTER GARDEN FL
34787-3546
US

V. Phone/Fax

Practice location:
  • Phone: 407-905-8827
  • Fax: 407-660-1667
Mailing address:
  • Phone: 407-905-8827
  • Fax: 407-660-1667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6748
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: