Organization
BETHANY L BREMER OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETHANY L. BREMER (OWNER)
(561) 881-8006
Entity
Organization
Contact information
Practice address
101 N. CONGRESS AVE, LAKE PARK, FL 33403
(561) 881-8006
Mailing address
101 N CONGRESS AVE, LAKE PARK, FL 33403-3804
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2606
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621230100
—
FL
Enumeration date
05/03/2007
Last updated
04/25/2013
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