Individual
PHILIP DESANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1850 SW GATLIN BLVD, WALMART OPTICAL, PORT SAINT LUCIE, FL 34953-2703
(772) 343-0003
(772) 336-9017
Mailing address
1850 SW GATLIN BLVD, WALMART OPTICAL, PORT SAINT LUCIE, FL 34953-2703
(772) 343-0003
(772) 336-9017
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 2169
FL
Other
Enumeration date
02/27/2007
Last updated
12/07/2010
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