Individual
DEBORAH L CONSBRUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
502 E NEW HAVEN AVE, MELBOURNE, FL 32901-5427
(321) 727-2020
(321) 984-9547
Mailing address
502 E NEW HAVEN AVE, MELBOURNE, FL 32901-5427
(321) 727-2020
(321) 984-9547
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6025/T2940
OH
152W00000X
Optometrist
OPC4867
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105446
—
OH
05
—
020792100
—
FL
05
—
7100306830
—
KY
Enumeration date
02/15/2012
Last updated
07/21/2022
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