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General NPI Number Information
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NPI Number | 1992925929
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Entity Type | Individual
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Provider Name | GUILHERME WILLIAM DWIN LDO
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 1767 N UNIVERSITY DR
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City | PLANTATION
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State | FL
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Zip | 33322-4111
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Country | US
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Telephone | 954-472-2422
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Fax | 954-476-2023
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Provider Business Mailing Address
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Address Line | 1767 N UNIVERSITY DR
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City | PLANTATION
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State | FL
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Zip | 33322-4111
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Country | US
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Telephone | 954-472-2422
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Fax | 954-476-2023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 1171
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License Number State | FL
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