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DR. HOWARD BOLOS O.D.

Corneal and Contact Management >> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1609984665

Individual Registrant:
DR. HOWARD  BOLOS O.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
113 MARYLAND AVE  COCOA, FL 32922-7832 US
Tel: 321-636-4422  Fax: 321-632-9254

Contact information for business:
113 MARYLAND AVE  COCOA, FL 32922-7832 US
Tel: 321-636-4422  Fax: 321-632-9254

Registration Information:
NPI: 1609984665
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N152WC0802XEye and Vision Services Providers
Optometrist
Corneal and Contact Management
FLOPC 001719
Y152W00000XEye and Vision Services Providers
Optometrist
FLOPC1719

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
078230100FL05




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