Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC2601 | FL |
NPI | 1003918442 |
---|---|
Provider Name | Dr. Brenda Catineau Hart |
First Address | Fort Myers, FL 33912-4693 |
Second Address | Fort Myers, FL 33912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 11/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
086874400 | (05) | FL |
U39761 | (02) | FL |