Individual
LAUREN NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-4200
(954) 262-2269
Mailing address
PO BOX 290370, DAVIE, FL 33329-0370
(954) 262-4200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5701
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103676100
—
FL
Enumeration date
05/17/2019
Last updated
10/30/2019
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