Individual
DR. MIGUEL DE FALCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
169 JENNIFER RD STE D, ANNAPOLIS, MD 21401
(410) 224-0021
(410) 224-2098
Mailing address
169 JENNIFER RD STE D, ANNAPOLIS, MD 21401-4170
(410) 224-0021
(410) 224-2098
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4014
FL
152W00000X
Optometrist
Primary
TA2546
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621106200
—
FL
05
—
621106201
—
FL
01
—
U7266W
PTAN
FL
Enumeration date
03/23/2006
Last updated
07/12/2019
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