Individual
MARK C HETHERINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3435 49TH ST N, SUITE A, ST PETERSBURG, FL 33710-2147
(727) 522-8423
(727) 521-1886
Mailing address
3435 49TH ST N, SUITE A, ST PETERSBURG, FL 33710-2147
(727) 522-8423
(727) 521-1886
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC-2183
FL
152W00000X
Optometrist
Primary
OPC2813
FL
Other
Enumeration date
09/21/2006
Last updated
08/13/2016
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