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Organization

ANNETTE BRABHAM OD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANNETTE BRABHAM O.D (OWNER/DOCTOR)
(850) 729-8711
Entity
Organization

Contact information

Practice address
111 N JOHN SIMS PKWY, VALPARAISO, FL 32580-1005
(850) 729-8711
(850) 729-8713
Mailing address
111 N JOHN SIMS PKWY, VALPARAISO, FL 32580-1005
(850) 729-8711
(850) 729-8713

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP0002698
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
620523200
FL
Enumeration date
01/04/2011
Last updated
06/17/2013
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