John Tivnan O.D.

NPI 1013911379 - Optometrist - 152W00000X

NPI Details
NPI 1013911379
Gender Male
Enumeration Date 06/02/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
407 AVENUE K SE
WINTER HAVEN FL, 33880-4126, US
Phone (863) 294-3504
Fax (863) 299-0096
Business Location
407 AVENUE K SE
WINTER HAVEN FL, 33880-4126, US
Phone (863) 294-3504
Fax (863) 299-0096
Toxanomy
Taxonomy Code 152W00000X
License State Florida
License Number OPC 1060
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According to our database, Dr. John Tivnan O.D. NPI is 1013911379, taxonomy code is 152W00000X and license number is OPC 1060, license state is located at Florida. John Tivnan O.D. physically located at 407 Avenue K Se, Winter Haven FL, 33880-4126. NPI Number John Tivnan O.D. has the Individual type.

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1013911379 NPI number is provided on an as is basis without warranty of any kind. 1013911379 is maintained by the National Plan & Provider Enumeration System. The contents of John Tivnan O.D. are for informational purposes only.