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General NPI Number Information
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NPI Number | 1316243900
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Entity Type | Organization
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Legal Business Name | DR RONALD A CAMPBELL OD PA
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 3111 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32803-5107
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Country | US
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Telephone | 407-898-0909
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Fax | 407-897-3565
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Provider Business Mailing Address
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Address Line | 4455 HARBOUR LIGHTS CT
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City | ORLANDO
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State | FL
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Zip | 32817-1208
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Country | US
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Telephone | 407-929-9035
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Fax | 407-897-3565
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD A CAMPBELL
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Credential | OD
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Telephone | 407-929-9035
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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 | OPC2441
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License Number State | FL
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