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Individual

RACHEL ANN DE LA RIVA MARCY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
5727 CANTON CV, SUITE 111, WINTER SPRINGS, FL 32708-5033
(407) 695-2020
(407) 699-5666
Mailing address
160 BOSTON AVE, ALTAMONTE SPRINGS, FL 32701-4798
(407) 775-7654
(407) 834-6082

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
007641
NY
152W00000X
Optometrist
Primary
OPC4629
FL
152W00000X
Optometrist
OPT002618
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004538300
FL
Enumeration date
06/08/2011
Last updated
05/05/2017
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