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General NPI Number Information
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NPI Number | 1740416718
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Entity Type | Organization
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Legal Business Name | WILLIAM E RIEHL JR OD PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 06/04/2009
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 6200 20TH ST ROOM 850
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City | VERO BEACH
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State | FL
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Zip | 32966-1012
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Country | US
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Telephone | 772-567-9142
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Fax |
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Provider Business Mailing Address
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Address Line | 2532 N HIGHWAY A1A
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City | INDIALANTIC
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State | FL
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Zip | 32903-2300
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Country | US
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Telephone | 954-557-6823
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM RIEHL JR.
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Credential | OD
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Telephone | 954-557-6823
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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 | 1959
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License Number State | FL
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