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Individual

OLIVIA ANNE LONGO VIII

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1661 SE US HIGHWAY 19, CRYSTAL RIVER, FL 34429-4830
(352) 563-1666
(352) 229-4443
Mailing address
4359 35TH ST N, ST PETERSBURG, FL 33714-3717
(727) 914-8615
(727) 914-8610

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO6546
FL

Other

Enumeration date
07/25/2018
Last updated
07/25/2018
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