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Individual

DR. DOUGLAS E. RADISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
24420 SANDHILL BLVD, UNIT 101, PUNTA GORDA, FL 33983-5272
(941) 255-5776
(941) 255-9105
Mailing address
65 CABELLO ST, PUNTA GORDA, FL 33983-5206
(941) 255-5776
(941) 255-9105

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1796
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78421400
FL
Enumeration date
07/12/2005
Last updated
10/22/2013
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