Organization
DEBRA A. SHIM, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA A SHIM O.D. (OPTOMETRIST/OWNER)
(561) 625-4380
Entity
Organization
Contact information
Practice address
451 UNIVERSITY BLVD, SUITE 102, JUPITER, FL 33458-3102
(561) 625-4380
(561) 625-3920
Mailing address
451 UNIVERSITY BLVD, SUITE 102, JUPITER, FL 33458-3102
(561) 625-4380
(561) 625-3920
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 3312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL589A
MEDICARE PTAN
—
Enumeration date
11/02/2009
Last updated
02/23/2010
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