Organization
MICHELLE R ROUNTREE O D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE R ROUNTREE OD (OPTOMETRIST SOLE OWNER)
(954) 885-8488
Entity
Organization
Contact information
Practice address
10800 PINES BLVD, STE 7, PEMBROKE PINES, FL 33026
(954) 885-8488
(954) 885-4919
Mailing address
10800 PINES BLVD, STE 7, PEMBROKE PINES, FL 33026-5216
(954) 885-8488
(954) 885-4919
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AF 740
MEDICARE PTAN
FL
Enumeration date
04/27/2007
Last updated
02/29/2008
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