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General NPI Number Information
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NPI Number | 1598069353
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Entity Type | Organization
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Legal Business Name | BRIAN J SHENKER O.D., P.A.
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Dates
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Enumeration Date | 01/07/2011
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 2600 SW 19TH AVENUE RD
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City | OCALA
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State | FL
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Zip | 34471-1393
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Country | US
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Telephone | 352-237-1626
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Fax |
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Provider Business Mailing Address
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Address Line | 8507 SW 72ND LN
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City | GAINESVILLE
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State | FL
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Zip | 32608-5681
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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 | OPTOMETRIST
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Name | BRIAN SHENKER
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Credential | O.D.
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Telephone | 954-249-9901
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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 | OPC 3726
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License Number State | FL
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