NPI 1679044739 · live from the CMS NPI Registry
Advanced Clinical Eyecare Of Southern Maine, P.C.
Optometrist in South Portland, ME. National Provider Identifier 1679044739, active.
NPI record
| NPI | 1679044739 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 335 Maine Mall Rd, South Portland, ME 04106 |
| Practice phone | 207-771-7968 |
| Enumerated | December 16, 2018 |
| Last updated | February 13, 2019 |
| Authorized official | Jonathan Olmes, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.