Individual
PAUL DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1850 SW GATLIN BLVD, PORT ST LUCIE, FL 34953-2703
(772) 336-9281
Mailing address
7835 SADDLEBROOK DR, PORT SAINT LUCIE, FL 34986-3130
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC-5767
FL
Other
Enumeration date
05/29/2020
Last updated
09/23/2021
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