Agostinelli, Elise Debruler

Agostinelli, Elise Debruler is an sole proprietor health care provider with primary practice located at 1720 University Blvd , Birmingham AL 35233-1816. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Agostinelli, Elise Debruler can be contacted via phone (205) 488-0736.

Contact Information

Primary practice address
1720 University Blvd Birmingham AL 35233-1816
Phone: (205) 488-0736
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X S-E53-TA-B84 Alabama

Profile Details

NPI number 1013528579
LBN Legal business name Agostinelli, Elise Debruler
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2020
Last updated Jun 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013528579 NPPES
Alabama MEDICAID S-E53-TA-B84

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