Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | FL3116 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | FL3116 | FL |
NPI | 1003968751 |
---|---|
Provider Name | Dr. Massimo R Gramanzini |
First Address | Plantation, FL 33323-2233 |
Second Address | Plantation, FL 33323-2233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 07/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U69523 | (02) | FL |