Individual
LEA KAY SPEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
207 N MAIN ST, CRESTVIEW, FL 32536-3543
(850) 683-0221
(850) 683-0225
Mailing address
207 N MAIN ST, CRESTVIEW, FL 32536-3543
(850) 683-0221
(850) 683-0225
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4350
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000859600
—
FL
01
—
02237
BLUE CROSS AND BLUE SHIELD OF FLORIDA
FL
Enumeration date
08/27/2008
Last updated
08/24/2011
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