Organization
LOW VISION OF PANAMA CITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE QUESADA MOORE OD (OWNER)
(850) 769-1404
Entity
Organization
Contact information
Practice address
826 HARRISON AVE, PANAMA CITY, FL 32401-2526
(850) 769-1404
(850) 769-0748
Mailing address
826 HARRISON AVE, PANAMA CITY, FL 32401-2526
(850) 769-1404
(850) 769-0748
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC5212
FL
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
OPC5212
FL
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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