Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | OPC1848 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC1848 | FL |
NPI | 1245374370 |
---|---|
Provider Name | William Glynn Leffler JR. |
First Address | Palm Beach Gardens, FL 33410 |
Second Address | Palm Beach Gardens, FL 33410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T93913 | (02) | FL |