Individual
DIANE LEE VIOLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
10041A US HIGHWAY 19, PORT RICHEY, FL 34668-3742
(727) 868-0780
(727) 868-0819
Mailing address
10041A US HIGHWAY 19, PORT RICHEY, FL 34668-3742
(727) 868-0780
(727) 868-0819
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO3953
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630276900
—
FL
Enumeration date
06/11/2008
Last updated
06/11/2008
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