Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO6774 | FL |
NPI | 1073020855 |
---|---|
Provider Name | Mr. Franddy Simplice |
First Address | North Miami, FL 33167-2847 |
Second Address | North Miami, FL 33167-2847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2018 |
Last Update Date | 03/01/2018 |