Individual
KRISHSAYI MATHANARUBAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
9428 W COLONIAL DR, OCOEE, FL 34761-6800
(407) 291-1921
Mailing address
5607 JOHNS RD, TAMPA, FL 33634-4499
(813) 885-3937
(813) 880-8375
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC6374
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPC6374
OPTOMETRY LICENSE
FL
Enumeration date
11/28/2023
Last updated
11/28/2023
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