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Individual

FRANK ANTHONY BROOME III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
125 SW MIDTOWN PL, SUITE 101, LAKE CITY, FL 32025-0766
(386) 466-1062
(386) 466-1061
Mailing address
125 SW MIDTOWN PL, SUITE 101, LAKE CITY, FL 32025-0766
(386) 466-1062
(386) 466-1061

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2440
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
078744200
FL
Enumeration date
11/07/2005
Last updated
09/09/2016
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