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Individual

DOMINIC JAMES PASTORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1000 N WICKHAM RD, MELBOURNE, FL 32935-8937
(321) 259-1699
(321) 259-4658
Mailing address
PO BOX 560580, ROCKLEDGE, FL 32956-0580
(321) 693-1534
(321) 259-4658

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 3723
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20680
BCBS OF FL
FL
05
620836300
FL
Enumeration date
05/31/2006
Last updated
10/27/2010
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