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Individual
DR. JAMES MICHAEL PETRO
Active
Individual
DR. JAMES MICHAEL PETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3266
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC3266
FL
152WP0200X
Pediatric Optometrist
OPC3266
FL
152WS0006X
Sports Vision Optometrist
OPC3266
FL
152WX0102X
Occupational Vision Optometrist
OPC3266
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11221055
CAQH PROVIDER
—
Enumeration date
04/24/2007
Last updated
10/25/2018
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