Individual provider · NPI-1
Annabelle Wilcox, LDO
Technician/Technologist, Optician · Destin, FL
NPI number1174317176
StatusActive
Last updated in NPPESApr 7, 2025
Details
- NPI
- 1174317176
- Entity type
- Individual (NPI-1)
- Name
- Annabelle Wilcox
- Credential
- LDO
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 7, 2025
- Certification date
- Apr 4, 2025
- Last updated
- Apr 7, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 6905 | FL | Yes |
Practice location
15017 Emerald Coast PkwyDestin, FL 32541-3358
Phone 850-650-0353
Mailing address
15017 Emerald Coast PkwyDestin, FL 32541-3358
Phone 850-650-0353
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