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Individual

ELISSAGE JEAN-BAPTISTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICENSED OPTICIAN

Contact information

Practice address
12555 W SUNRISE BLVD, SUNRISE, FL 33323-0900
(954) 845-0647
(954) 845-0289
Mailing address
18572 SW 42ND ST, MIRAMAR, FL 33029-2774
(786) 205-2887

Taxonomy

Speciality
Code
Description
License number
State
152WX0102X
Occupational Vision Optometrist
Primary
5135
FL

Other

Enumeration date
03/06/2024
Last updated
03/06/2024
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