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Individual

ANNETTE BRABHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
111 N JOHN SIMS PKWY, VALPARAISO, FL 32580
(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
10/03/2006
Last updated
06/15/2018
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