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General NPI Number Information
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NPI Number | 1740893692
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Entity Type | Organization
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Legal Business Name | DRMARIA LOULOURGAS PA
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 928 CURLEW RD
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City | DUNEDIN
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State | FL
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Zip | 34698-1901
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Country | US
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Telephone | 727-641-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 4977 TURTLE CREEK TRL
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City | OLDSMAR
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State | FL
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Zip | 34677-1966
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Country | US
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Telephone | 727-641-3937
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | MARIA LOULOURGAS
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Credential |
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Telephone | 727-641-3937
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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 |
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