Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC2692 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC002692 | FL |
NPI | 1073515284 |
---|---|
Provider Name | Dr. Michael Stuart Nason |
First Address | West Palm Beach, FL 33409-4762 |
Second Address | West Palm Beach, FL 33409-4762 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 26/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
620019200 | (05) | FL |
FL2692 | EYEMED (01) | FL |
U51433 | (02) | FL |