Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC5667 | FL |
NPI | 1003475096 |
---|---|
Provider Name | Dr. Carlos Naguib |
First Address | Tampa, FL 33618-2446 |
Second Address | Tampa, FL 33618-2446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2019 |
Last Update Date | 31/12/2020 |