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Organization
LOW VISION OF PANAMA CITY LLC
Active
Organization
LOW VISION OF PANAMA CITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE QUESADA MOORE OD (OWNER)
(850) 769-1404
Entity
Organization
Contact information
Practice address
826 HARRISON AVE, PANAMA CITY, FL 32401-2526
(850) 769-1404
(850) 769-0748
Mailing address
826 HARRISON AVE, PANAMA CITY, FL 32401-2526
(850) 769-1404
(850) 769-0748
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC5212
FL
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
OPC5212
FL
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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