Peterson, Brian Michael

Peterson, Brian Michael is an sole proprietor health care provider with primary practice located at 15 Cypress Branch Way Ste 205 , Palm Coast FL 32164-8414. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Peterson, Brian Michael can be contacted via phone (386) 445-1880.

Contact Information

Primary practice address
15 Cypress Branch Way Ste 205 Palm Coast FL 32164-8414
Phone: (386) 445-1880
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC 4830 Florida

Profile Details

NPI number 1477987741
LBN Legal business name Peterson, Brian Michael
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2013
Last updated Sep 30th, 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 1477987741 NPPES
Florida Other OPC 4830 FLORIDA LICENSE NUMBER

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