Organization
FLORIDA OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN K FUSSELMAN O.D. (OWNER/PRESIDENT)
(407) 862-7699
Entity
Organization
Contact information
Practice address
1011 W VINE ST, KISSIMMEE, FL 34741-4166
(407) 862-7699
(407) 862-9672
Mailing address
1011 W VINE ST, KISSIMMEE, FL 34741-4166
(407) 862-7699
(407) 862-9672
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1993
FL
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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