Paul G Rousseau Od Pa | |
5455 Murrell Rd Ste 107 Viera FL 32955-6615 | |
(321) 636-1972 | |
(321) 636-1507 |
Full Name | Paul G Rousseau Od Pa |
---|---|
Speciality | Clinic/Center |
Location | 5455 Murrell Rd Ste 107, Viera, Florida |
Authorized Official Name and Position | Paul Gerard Rousseau (DEVELOPMENTAL OPTOMETRIST) |
Authorized Official Contact | 3216361972 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Paul G Rousseau Od Pa 5455 Murrell Rd Ste 107 Viera FL 32955-6615 Ph: (321) 636-1972 | Paul G Rousseau Od Pa 5455 Murrell Rd Ste 107 Viera FL 32955-6615 Ph: (321) 636-1972 |
NPI Number | 1265762918 |
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Provider Enumeration Date | 12/31/2009 |
Last Update Date | 05/03/2012 |
Medicare PECOS PAC ID | 0547392656 |
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Medicare Enrollment ID | O20100723000884 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265762918 | NPI | - | NPPES |
20396Z | Other | FL | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | OPC2641 (Florida) | Primary |
Provider Name | Paul G Rousseau |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1427271857 PECOS PAC ID: 2264565357 Enrollment ID: I20100726000602 |
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