Individual
ELISA MARIE PUERTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1452 CLARET CT, FORT MYERS, FL 33919-3458
(239) 634-0583
Mailing address
1452 CLARET CT, FORT MYERS, FL 33919-3458
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5900
FL
Other
Enumeration date
08/07/2021
Last updated
08/07/2021
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