Organization
MARTIN A KANSOL OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN A KANSOL (OWNER)
(407) 321-6434
Entity
Organization
Contact information
Practice address
3098 W LAKE MARY BLVD, LAKE MARY, FL 32746-6742
(407) 321-6434
Mailing address
3098 W LAKE MARY BLVD, LAKE MARY, FL 32746-6742
(407) 321-6434
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC002152
FL
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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