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General NPI Number Information
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NPI Number | 1588910640
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Entity Type | Organization
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Legal Business Name | INGRID WHITBOURNE-COOKE, O.D.,P.A.
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Dates
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Enumeration Date | 07/26/2012
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 4181 N PINE ISLAND RD
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City | SUNRISE
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State | FL
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Zip | 33351-6040
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Country | US
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Telephone | 954-572-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 4181 N PINE ISLAND RD
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City | SUNRISE
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State | FL
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Zip | 33351-6040
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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
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Name | DR. INGRID WHITBOURNE-COOKE
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Credential | O.D.
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Telephone | 954-572-0888
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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 | OPC3064
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License Number State | FL
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