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General NPI Number Information
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NPI Number | 1306367461
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Entity Type | Organization
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Legal Business Name | IFOCUS OPTOMETRY INC
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 06/29/2017
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Provider Practice Location Address
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Address Line | 8177 GLADES RD STE 3
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City | BOCA RATON
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State | FL
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Zip | 33434-4063
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Country | US
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Telephone | 561-479-4765
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Fax |
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Provider Business Mailing Address
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Address Line | 2036 DISCOVERY CIR E
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1044
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OPTOMETRIST
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Name | DR. SCOTT MERVYN BROWN
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Credential | OD
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Telephone | 954-304-7850
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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 | 004116
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License Number State | FL
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