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Individual
SUSAN LA GRECA BECK
Active
Individual
SUSAN LA GRECA BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618001274
VA
152W00000X
Optometrist
OP764
DC
152W00000X
Optometrist
Primary
OPC4254
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621330800
—
FL
Enumeration date
03/05/2007
Last updated
03/03/2010
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