Individual
DR. LEONARD RAYMOND MAIOLATESI JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9350 HIGHWAY 49, GULFPORT, MS 39503-4213
(228) 863-1859
Mailing address
1200 MAGNOLIA BAYOU BLVD, OCEAN SPRINGS, MS 39564-1203
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
711
MS
Other
Enumeration date
06/23/2007
Last updated
07/08/2007
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