Individual
DA SHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7731 GALL BLVD, ZEPHYRHILLS, FL 33541-4315
(656) 900-3000
Mailing address
5188 COUNSELOR DR UNIT 304, ZEPHYRHILLS, FL 33541-2357
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6561
FL
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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