Individual
FREDY A OTALORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8051 W SUNRISE BLVD, SUNRISE, FL 33322
(954) 474-2900
(954) 474-2901
Mailing address
PO BOX 39209, FT LAUDERDALE, FL 33339
(954) 851-9966
(954) 318-7360
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4484
FL
Other
Enumeration date
08/28/2009
Last updated
03/23/2021
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