Individual
DR. KALEN MILES THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2003 CORTEZ RD W, BRADENTON, FL 34207-1241
(941) 756-2020
Mailing address
2003 CORTEZ RD W, BRADENTON, FL 34207-1241
(941) 756-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC6244
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPC6244
PROFESSIONAL LISCENSE
FL
Enumeration date
06/05/2023
Last updated
10/03/2024
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