Individual
MUKTIAR IDREES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1860 N PINE ISLAND RD STE 105, PLANTATION, FL 33322-5234
(754) 216-8333
Mailing address
1860 N PINE ISLAND RD STE 105, PLANTATION, FL 33322-5234
(754) 216-8333
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108026100
—
FL
Enumeration date
01/21/2021
Last updated
01/21/2021
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