Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1670 | FL |
NPI | 1033439195 |
---|---|
Provider Name | Ms. Karen Yvonne Martin |
First Address | Sarasota, FL 34231-7004 |
Second Address | Sarasota, FL 34239-2340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2010 |
Last Update Date | 10/06/2010 |