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General NPI Number Information
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NPI Number | 1124520481
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Entity Type | Organization
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Legal Business Name | 20/20 EYE CARE ON CURRY FORD LLC
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 4507 CURRY FORD RD
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City | ORLANDO
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State | FL
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Zip | 32812-2710
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Country | US
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Telephone | 407-277-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 4507 CURRY FORD RD
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City | ORLANDO
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State | FL
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Zip | 32812-2710
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Country | US
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Telephone | 407-277-2020
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Fax |
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Authorized Official
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Title or Position | OD
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Name | DR. PAMELA J BLADE
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Credential | OD
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Telephone | 407-277-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC5035
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License Number State | FL
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