# C S PETERS OD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477853364
- **Authorized official:** C S PETERS (PRESIDENT)
- **Authorized official phone:** (850) 678-1722

## Contact information

- **Practice address:** 111 N JOHN SIMS PKWY, VALPARAISO, FL 32580-1005
- **Practice address phone:** (850) 678-1722
- **Mailing address:** 111 N JOHN SIMS PKWY, VALPARAISO, FL 32580-1005
- **Mailing address phone:** (850) 678-1722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OP0001109 | FL | Yes |

## Other

- **Enumeration date:** 10/26/2010
- **Last updated:** 12/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 084488800 | — | FL |