Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 751 | FL |
NPI | 1033298013 |
---|---|
Provider Name | Mr. Stanley J Elbrand |
First Address | North Miami Beach, FL 33162-4623 |
Second Address | North Miami Beach, FL 33162-4623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0867021000 | (05) | FL |