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Individual

RAYMOND AMADO HERMIDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2229 W NEW HAVEN AVE, MELBOURNE, FL 32904-3805
(321) 726-6551
(321) 726-0443
Mailing address
2229 W NEW HAVEN AVE, MELBOURNE, FL 32904-3805
(321) 726-6551
(321) 726-0443

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2898
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC2898
FL
152WS0006X
Sports Vision Optometrist
OB2475
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
620265900
FL
Enumeration date
06/08/2006
Last updated
02/13/2014
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