Individual provider · NPI-1
Tamika Prentisa Bermejo
Technician/Technologist, Optician · Toledo, OH
NPI number1356042592
StatusActive
Last updated in NPPESMar 14, 2023
Details
- NPI
- 1356042592
- Entity type
- Individual (NPI-1)
- Name
- Tamika Prentisa Bermejo
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2023
- Certification date
- Mar 14, 2023
- Last updated
- Mar 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | op.017132-s | OH | Yes |
| 156FX1800X | Technician/Technologist, Optician | – | – |
Practice location
2925 Glendale AveToledo, OH 43614-2684
Phone 419-380-8769 · Fax 419-380-8921
Mailing address
2925 Glendale AveToledo, OH 43614-2684
Phone 419-380-8769 · Fax 419-380-8921
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