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General NPI Number Information
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NPI Number | 1205011863
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Entity Type | Organization
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Legal Business Name | JOHN PATRICK BRENNAN OD PA
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 710 S PARROTT AVE
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City | OKEECHOBEE
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State | FL
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Zip | 34974-5138
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Country | US
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Telephone | 863-467-0595
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Fax | 863-467-1686
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Provider Business Mailing Address
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Address Line | 710 S PARROTT AVE
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City | OKEECHOBEE
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State | FL
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Zip | 34974-5138
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Country | US
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Telephone | 863-467-0595
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Fax | 863-467-1686
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN PATRICK BRENNAN SR.
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Credential | OD PA
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Telephone | 863-467-0595
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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 | FLOPC971
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License Number State | FL
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