Organization
GATLIN VISION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP C DESANTIS D.O. (PRESIDENT)
(954) 821-1111
Entity
Organization
Contact information
Practice address
1850 SW GATLIN BLVD, PORT ST LUCIE, FL 34953-2703
(772) 343-0003
Mailing address
1850 SW GATLIN BLVD, PORT ST LUCIE, FL 34953-2703
(772) 343-0003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2169
FL
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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