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Individual

CLIVE LATTIBEAUDIERE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10057 SUNSET STRIP STE B, SUNRISE, FL 33322-5301
(954) 749-5881
(954) 572-4822
Mailing address
10057 SUNSET STRIP STE B, SUNRISE, FL 33322-5301

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO6278
FL

Other

Enumeration date
10/23/2014
Last updated
10/23/2014
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