Organization
QING GE, M.D.
Active
Other names
Premier Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QING GE M.D., PH.D. (MEDICAL DIRECTOR)
(386) 788-6198
Entity
Organization
Contact information
Practice address
1515 HERBERT ST, SUITE 208, PORT ORANGE, FL 32129-6104
(386) 788-6198
(386) 788-4616
Mailing address
1515 HERBERT ST, SUITE 208, PORT ORANGE, FL 32129-6104
(386) 788-6198
(386) 788-4616
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
ME 96155
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277580800
—
FL
Enumeration date
07/09/2009
Last updated
09/09/2009
Update your record
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