Organization
MICHAEL O. BRODER, OD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE ELLEN BARTON (RECEPTIONIST)
(941) 493-8787
Entity
Organization
Contact information
Practice address
2165 TAMIAMI TRL S, VENICE, FL 34293-5034
(941) 493-8787
(941) 408-8446
Mailing address
2165 TAMIAMI TRL S, VENICE, FL 34293-5034
(941) 493-8787
(941) 408-8446
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP0002949
FL
Other
Enumeration date
10/15/2010
Last updated
10/27/2010
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