Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | OEG002557 | PA |
Y | 152W00000X | Optometrist | OPC4665 | FL |
N | 152W00000X | Optometrist | TUV007963 | NY |
NPI | 1013291566 |
---|---|
Provider Name | Dr. Bruce Caide Barbon |
First Address | Fort Myers, FL 33905-5535 |
Second Address | Cape Coral, FL 33909-5422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2011 |
Last Update Date | 27/09/2016 |