| |
1917 Knox Mcrae Dr, Titusville, FL 32780-5360 | |
(321) 383-1332 | |
(321) 383-1243 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1917 Knox Mcrae Dr, Titusville, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164660221 | NPI | - | NPPES |
18692A | Other | FL | 2ND OFFICE LOCATION |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPC4171 (Florida) | Secondary |
207W00000X | Ophthalmology | ME0062417 (Florida) | Primary |
Mailing Address | Practice Location Address |
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1917 Knox Mcrae Dr, Titusville, FL 32780-5360 Ph: (321) 383-1332 | 1917 Knox Mcrae Dr, Titusville, FL 32780-5360 Ph: (321) 383-1332 |