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Individual

DR. MITCHELL S BIDERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2305 OLEANDER BLVD, FORT PIERCE, FL 34982-5830
(772) 465-6616
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1718
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19949
BC/BS
FL
01
410049282
RAILROAD
FL
05
620802900
FL
Enumeration date
07/21/2006
Last updated
11/14/2023
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