Individual
DR. KRISTINE THAO SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
703 N MAIN ST, KISSIMMEE, FL 34744-5265
(504) 355-6026
Mailing address
3601 VALLEYVIEW DR, KISSIMMEE, FL 34746-2895
(504) 355-6026
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5446
FL
Other
Enumeration date
07/19/2017
Last updated
03/17/2018
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