Individual
DR. CONNIE LAWRENCE-WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2001 US HIGHWAY 1, SEBASTIAN, FL 32958-1615
(772) 589-7337
(772) 589-0707
Mailing address
2001 US HIGHWAY 1, SEBASTIAN, FL 32958-1615
(772) 589-7337
(772) 589-0707
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3016
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
711203
EYEMED PROVIDER ID
FL
Enumeration date
09/04/2006
Last updated
07/08/2007
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