Individual
DR. LARISSA DVORAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1590 DUNLAWTON AVE, PORT ORANGE, FL 32127-4752
(386) 756-1900
(386) 756-8133
Mailing address
6715 FERRI CIR, PORT ORANGE, FL 32128-6031
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3433
FL
Other
Enumeration date
06/10/2010
Last updated
06/10/2010
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