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General NPI Number Information
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NPI Number | 1326988494
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Entity Type | Individual
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Provider Name | DARRAH SUSAN POTTS
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Gender | Female
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 2700 CLEARLAKE RD
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City | COCOA
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State | FL
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Zip | 32922-5716
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Country | US
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Telephone | 321-631-0373
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Fax | 321-631-0375
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Provider Business Mailing Address
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Address Line | 6085 CHAPMAN ST
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City | COCOA
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State | FL
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Zip | 32927-8807
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Country | US
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Telephone | 321-631-0373
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Fax | 321-631-0375
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | DO6596
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License Number State | FL
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