Individual
CAMILA DIAZ LEGRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSE OPTICIAN
Contact information
Practice address
11110 CAUSEWAY BLVD, BRANDON, FL 33511-2900
(813) 657-4810
(813) 657-3721
Mailing address
11110 CAUSEWAY BLVD, BRANDON, FL 33511-2900
(813) 657-4810
(813) 657-3721
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1808
FL
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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