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Organization
BROOME VISION INC.
Active
Organization
BROOME VISION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ANDREW BROOME O.D. (PRESIDENT/OWNER)
(386) 253-5999
Entity
Organization
Contact information
Practice address
3781O S NOVA RD STE O, PORT ORANGE, FL 32129-4233
(386) 760-8626
(386) 760-2676
Mailing address
3781 S NOVA RD STE O, PORT ORANGE, FL 32129-4285
(386) 760-8626
(386) 760-2676
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3301
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000206403
—
FL
Enumeration date
07/08/2008
Last updated
06/02/2011
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