Mark Joseph Bridges, L.D.O.
Technician/Technologist, Optician in Lakeland, FL. Individual provider (NPI-1).
NPI number1619078649
StatusActive
Last updated in NPPESNov 16, 2007
Details
- NPI
- 1619078649
- Entity type
- Individual (NPI-1)
- Name
- Mr. Mark Joseph Bridges
- Credential
- L.D.O.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 25, 2006
- Last updated
- Nov 16, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 1564 | FL | Yes |
Practice location
1600 Lakeland Hills BlvdLakeland, FL 33805-3019
Phone 863-682-3226 · Fax 863-682-1742
Mailing address
1600 Lakeland Hills BlvdLakeland, FL 33805-3019
Phone 863-682-3226 · Fax 863-682-1742
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