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Individual

DR. FALLON DE VAY HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
13800 VETERANS WAY, ORLANDO, FL 32827-7401
(407) 599-1404
Mailing address
822 KILLARNEY CT, MERRITT ISLAND, FL 32953-8065
(321) 514-2340

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC6523
FL

Other

Enumeration date
07/01/2024
Last updated
07/01/2024
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