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General NPI Number Information
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NPI Number | 1194152470
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Entity Type | Organization
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Legal Business Name | JAMES M NORMILE OD PA
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 3401 W SUNRISE BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311
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Country | US
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Telephone | 954-583-3471
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Fax | 954-584-3369
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Provider Business Mailing Address
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Address Line | 4597 SW 37TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-5403
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Country | US
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Telephone | 954-328-0751
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES NORMILE
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Credential |
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Telephone | 954-583-3471
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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 | OPC3499
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License Number State | FL
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