Individual
CUC THI LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
151 SW 184TH AVE, PEMBROKE PINES, FL 33029-5465
(954) 437-8777
Mailing address
13 MATADOR LN, DAVIE, FL 33324-5518
(954) 304-2724
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4752
FL
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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