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General NPI Number Information
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NPI Number | 1689008864
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Entity Type | Organization
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Legal Business Name | THOMAS D. MAUGER O.D., P.A.
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Dates
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Enumeration Date | 08/24/2013
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Last Update Date | 08/24/2013
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Provider Practice Location Address
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Address Line | 741 ORANGE AVE
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3031
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Country | US
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Telephone | 407-865-7009
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Fax | 407-786-7828
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Provider Business Mailing Address
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Address Line | 741 ORANGE AVE
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3031
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Country | US
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Telephone | 407-865-7009
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Fax | 407-786-7828
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS MAUGER
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Credential | O.D.
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Telephone | 407-865-7009
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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 | OPC2290
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License Number State | FL
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