Individual
DR. DENISE BURNS-LEGROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2420 S BABCOCK ST, MELBOURNE, FL 32901-5356
(321) 725-4755
(321) 725-5088
Mailing address
2420 S BABCOCK ST, MELBOURNE, FL 32901-5356
(321) 725-4755
(321) 725-5088
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPC4006
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10003
BCBS
FL
01
—
38200
BCBS
FL
01
—
38200A
BCBS
FL
05
—
621109700
—
FL
01
—
P00628284
RR MEDICARE
FL
Enumeration date
08/27/2006
Last updated
11/19/2008
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