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Organization

CORAL SPRINGS VISION CARE PLLC

Active
Other names
VISION SOURCE Coral Springs
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KATHERINE ORELLANA-MEDINA O.D. (MANAGER/OWNER)
(954) 753-0137
Entity
Organization

Contact information

Practice address
9773 W SAMPLE RD, CORAL SPRINGS, FL 33065-4003
(954) 753-0137
(954) 753-0139
Mailing address
9773 W SAMPLE RD, CORAL SPRINGS, FL 33065-4003
(954) 753-0137
(954) 753-0139

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 3853
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000557300
FL
01
FM674A
MEDICARE ID
Enumeration date
03/20/2010
Last updated
10/30/2013
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