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General NPI Number Information
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NPI Number | 1235796137
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Entity Type | Individual
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Provider Name | MICHAEL GARRETT MANN OD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2019
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 23 NE 44TH ST
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City | OAKLAND PARK
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State | FL
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Zip | 33334-1437
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Country | US
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Telephone | 954-257-3370
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Fax |
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Provider Business Mailing Address
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Address Line | 12767 NW 15TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-5438
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Country | US
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Telephone | 954-257-3370
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Fax |
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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 | 5664
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License Number State | FL
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