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General NPI Number Information
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NPI Number | 1689711194
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Entity Type | Individual
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Provider Name | ALBERT L HARRELL III O.D .
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 11924 W FOREST HILL BLVD SUITE 31
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City | WELLINGTON
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State | FL
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Zip | 33414-6256
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Country | US
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Telephone | 561-798-8282
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Fax | 561-798-2840
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Provider Business Mailing Address
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Address Line | 11924 W FOREST HILL BLVD SUITE 31
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City | WELLINGTON
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State | FL
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Zip | 33414-6256
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Country | US
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Telephone | 561-798-8282
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Fax | 561-798-2840
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OP 1746
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License Number State | FL
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