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NPI Code Detail

MEDICARE: DR. BETH ELISE NORRIS O.D.

MEDICARE: DR. BETH ELISE NORRIS O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPC 4465FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OPC4465OTHERFLMEDICAL LICENSE
212027906OTHERCAQH

General Provider Information

NPI Number : 1215199468
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BETH ELISE NORRIS O.D.
Provider Business Mailing Address
First Line : 7326 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-6055
Country : US
Telephone Number : 407-380-2020
Fax Number : 407-381-8112
Provider Business Practice Location Address
First Line : 7326 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-6055
Country : US
Telephone Number : 407-380-2020
Fax Number : 407-381-8112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2008
Last Update Date : 09/04/2014

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