Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO 5783 | FL |
NPI | 1114253291 |
---|---|
Provider Name | Mr. David M Kirschmann |
First Address | Tampa, FL 33647-2445 |
Second Address | Tampa, FL 33647-2445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2009 |
Last Update Date | 26/10/2009 |