Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | DO 5699 | FL |
N | 156FC0801X | Contact Lens Fitter | DO 5699 | FL |
N | 156FX1800X | Optician | DO 5699 | FL |
NPI | 1184840480 |
---|---|
Provider Name | Ms. Gilma Josefina Matos |
First Address | Doral, FL 33178 |
Second Address | Doral, FL 33178 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |