Organization
FAMILY VISION INSTITUTE OF SOUTH FLORIDA INC.
Active
Other names
Vision Source Fort Lauderdale
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON WILLIAM CORNISH O.D. (CEO)
(954) 522-3918
Entity
Organization
Contact information
Practice address
640 N FEDERAL HWY, FORT LAUDERDALE, FL 33304-4686
(954) 522-3918
(954) 522-5137
Mailing address
640 N FEDERAL HWY, FORT LAUDERDALE, FL 33304-4686
(954) 522-3918
(954) 522-5137
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621267100
—
FL
Enumeration date
01/22/2008
Last updated
10/30/2012
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