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Individual

MICHAEL L MAGGARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
13930 7TH ST, DADE CITY, FL 33525-4904
(352) 567-8989
(352) 567-0116
Mailing address
13930 7TH ST, DADE CITY, FL 33525-4904
(352) 567-8989
(352) 567-0116

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
OB 437
FL
152W00000X
Optometrist
Primary
OPC 1762
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410000386
RAILROAD MEDICARE
FL
Enumeration date
06/21/2005
Last updated
02/25/2021
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