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General NPI Number Information
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NPI Number | 1710969308
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Entity Type | Organization
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Legal Business Name | JOSEPH R DEVINE OD PA
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 948 N PINE HILLS RD
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City | ORLANDO
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State | FL
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Zip | 32808-7212
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Country | US
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Telephone | 407-295-1234
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Fax | 407-293-2867
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Provider Business Mailing Address
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Address Line | 948 N PINE HILLS RD
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City | ORLANDO
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State | FL
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Zip | 32808-7212
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Country | US
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Telephone | 407-295-1234
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Fax | 407-293-2867
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Authorized Official
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Title or Position | OPTOMETRIST OWNER
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Name | DR. JOSEPH ROCHE DEVINE
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Credential | OD
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Telephone | 407-295-1234
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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 |
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License Number State | FL
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