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Organization
ROGER A OTTO O D P A
Active
Organization
ROGER A OTTO O D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY FORD (OFFICE MANAGER)
(305) 294-9711
Entity
Organization
Contact information
Practice address
1444 KENNEDY DR, KEY WEST, FL 33040-4008
(305) 294-9711
(305) 294-8307
Mailing address
1444 KENNEDY DR, KEY WEST, FL 33040-4008
(305) 294-9711
(305) 294-8307
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1436
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084019000
—
FL
05
—
084967700
—
FL
Enumeration date
08/31/2007
Last updated
04/28/2008
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