Individual
N SCOTT GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1825 NE 164TH ST, NORTH MIAMI BEACH, FL 33162-4100
(305) 945-7113
Mailing address
3150 NE 190TH ST APT 104, AVENTURA, FL 33180-3175
(954) 806-8446
(866) 382-7695
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1086
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084468300
—
FL
Enumeration date
11/20/2006
Last updated
10/30/2019
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