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General NPI Number Information
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NPI Number | 1205993078
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Entity Type | Organization
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Legal Business Name | DRS SWANSON SOWERS LEE & YAGER PA
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 214 E MARKS ST
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City | ORLANDO
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State | FL
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Zip | 32803-3819
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Country | US
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Telephone | 407-841-6220
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Fax | 407-423-2285
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Provider Business Mailing Address
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Address Line | 214 E MARKS ST
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City | ORLANDO
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State | FL
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Zip | 32803-3819
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Country | US
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Telephone | 407-841-6220
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Fax | 407-423-2285
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. JACK J YAGER
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Credential | OD
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Telephone | 407-841-6220
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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 | FL1134
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License Number State | FL
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