Paul Desantis, OD
Optometrist in Port St Lucie, FL. Individual provider (NPI-1).
NPI number1033733720
StatusActive
Last updated in NPPESSep 23, 2021
Details
- NPI
- 1033733720
- Entity type
- Individual (NPI-1)
- Name
- Paul Desantis
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 29, 2020
- Certification date
- Sep 23, 2021
- Last updated
- Sep 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPC-5767 | FL | Yes |
Practice location
1850 Sw Gatlin BlvdPort St Lucie, FL 34953-2703
Phone 772-336-9281
Mailing address
7835 Saddlebrook DrPort Saint Lucie, FL 34986-3130
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All 29 Optometrist providers in Port St Lucie · All 3,747 providers in Port St Lucie
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