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General NPI Number Information
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NPI Number | 1215139282
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Entity Type | Individual
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Provider Name | KATHLEEN MARGARET MACRINA O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6275 NAPLES BLVD
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City | NAPLES
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State | FL
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Zip | 34109-2030
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Country | US
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Telephone | 239-596-6414
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Fax | 239-596-0030
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Provider Business Mailing Address
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Address Line | 5781 HAMMOCK ISLES DR
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City | NAPLES
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State | FL
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Zip | 34119-4695
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Country | US
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Telephone | 239-272-9031
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Fax | 239-596-0030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | FLOPC0000002862
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License Number State | FL
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