Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO4296 | FL |
NPI | 1124455472 |
---|---|
Provider Name | Mr. Marty L Schiffman |
First Address | Sunrise, FL 33351-6917 |
Second Address | Sunrise, FL 33351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2013 |
Last Update Date | 02/10/2013 |