Organization
DR LAWRENCE P FULLER OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE P FULLER OD (OPTOMETRIST SOLE PROVIDER)
(407) 846-2020
Entity
Organization
Contact information
Practice address
703 N MAIN ST, KISSIMMEE, FL 34744-5265
(407) 846-2020
(407) 846-8039
Mailing address
703 N MAIN ST, KISSIMMEE, FL 34744-5265
(407) 846-2020
(407) 846-8039
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC797
FL
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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