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General NPI Number Information
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NPI Number | 1790015675
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Entity Type | Organization
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Legal Business Name | ELIZABETH A. THOMPSON, O.D., P.A.
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 451 E ALTAMONTE DR STE 1467
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4616
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Country | US
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Telephone | 407-830-6546
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Fax |
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Provider Business Mailing Address
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Address Line | 451 E ALTAMONTE DR STE 1467
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4616
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Country | US
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Telephone | 407-830-6546
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELIZABETH THOMPSON
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Credential | O.D.
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Telephone | 407-324-5715
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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 | OPC002312
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License Number State | FL
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