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General NPI Number Information
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NPI Number | 1700123940
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Entity Type | Organization
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Legal Business Name | LAKE HOWELL EYE ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/08/2013
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 2008 LAKE HOWELL LANE
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City | MAITLAND
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State | FL
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Zip | 32751-5217
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Country | US
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Telephone | 407-647-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 LAKE HOWELL LN
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City | MAITLAND
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State | FL
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Zip | 32751-5202
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Country | US
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Telephone | 407-647-3937
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | DR. CHRISTOPHER J CHARNELL
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Credential |
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Telephone | 321-356-3423
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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 | OPC3824
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License Number State | FL
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