Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC 3672 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC 3672 | FL |
N | 152WP0200X | Pediatric Optomitrist | OPC 3672 | FL |
NPI | 1043312622 |
---|---|
Provider Name | Dr. Christopher Pearson |
First Address | Longwood, FL 32779-4806 |
Second Address | Longwood, FL 32779-4806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 24/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U92743 | (02) | FL |