Mr. Gary Johanson, LDO
Mr. Gary Johanson, LDO is an Optician in Daytona Beach, Florida. Licensed in Florida. Registered with an NPI since 2023.
- Licensed in
- FL
- In the registry since
- 2023
Practice location Address checks out
1460 Cornerstone BlvdDaytona Beach, FL 32117-7174
Phone: (386) 760-3330
Fax: (386) 274-2051
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Optician (primary) | Taxonomy 156FX1800X · Licence 01914 (FL) |
|---|
Record details
| NPI number | 1871286153 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | LDO |
| Sole proprietor | No |
| NPI enumerated | June 1, 2023 |
| Last updated in NPPES | June 1, 2023 |
| Certification date | June 1, 2023 |
| Mailing address | 1460 Cornerstone Blvd, Daytona Beach, FL 32117-7174 |
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