Individual
DR. LEANN J. MANDESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2194 A1A HWY, SUITE 109, INDIAN HARBOUR BEACH, FL 32937-4930
(321) 777-1670
(321) 773-0187
Mailing address
2194 HIGHWAY A1A STE 109-110, INDIAN HARBOUR BEACH, FL 32937-4930
(321) 777-1670
(321) 773-0187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP3125
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548473887
ORGANIZATION
FL
Enumeration date
10/31/2005
Last updated
03/15/2021
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