| C S Peters, OD PA | |
|
111 N John Sims Pkwy, Valparaiso, FL 32580-1005 | |
| (850) 678-1722 | |
| Not Available |
| Full Name | C S Peters |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 111 N John Sims Pkwy, Valparaiso, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902990161 | NPI | - | NPPES |
| 084488800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OP0001109 (Florida) | Primary |
| Provider Name | Annette Brabham Od Pa |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1255635348 PECOS PAC ID: 6406967546 Enrollment ID: O20120420000394 |
| Mailing Address | Practice Location Address |
|---|---|
| C S Peters, OD PA 111 N John Sims Pkwy, Valparaiso, FL 32580-1005 Ph: (850) 678-1722 | C S Peters, OD PA 111 N John Sims Pkwy, Valparaiso, FL 32580-1005 Ph: (850) 678-1722 |
Annette Brabham Od Pa Optometrist Medicare: Medicare Enrolled Practice Location: 111 N John Sims Pkwy, Valparaiso, FL 32580 Phone: 850-729-8711 Fax: 850-729-8713 | |
Branscome Vision Group Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 111 N John Sims Pkwy, Valparaiso, FL 32580 Phone: 850-758-8859 | |
Annette Brabham, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 111 N John Sims Pkwy, Valparaiso, FL 32580 Phone: 850-729-8711 Fax: 850-729-8713 | |
C S Peters Od, Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 111 N John Sims Pkwy, Valparaiso, FL 32580 Phone: 850-678-1722 |