Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC 3366 | FL |
NPI | 1992829543 |
---|---|
Provider Name | Victoria Melcher |
First Address | Madeira Beach, FL 33708 |
Second Address | St Petersburg, FL 33710-3039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 22/10/2012 |