Individual
MR. FABIAN ROBERTO BASTIDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.D.O.
Contact information
Practice address
33 SE OCEAN BLVD, STUART, FL 34994-2214
(772) 221-8878
(772) 221-8878
Mailing address
33 SE OCEAN BLVD, STUART, FL 34994-2214
(772) 221-8878
(772) 221-8878
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO3354
FL
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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