Basaly Demetrios, Romanda

Basaly Demetrios, Romanda is an individual health care provider with primary practice located at 155 Fountains Way Ste 11 , Saint Johns FL 32259-1144. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Basaly Demetrios, Romanda can be contacted via phone (404) 932-2802.

Contact Information

Primary practice address
155 Fountains Way Ste 11 Saint Johns FL 32259-1144
Phone: (404) 932-2802
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901004806 Michigan
Eye and Vision Services Providers / Optometrist 152W00000X OPT002962 Georgia
Eye and Vision Services Providers / Optometrist 152W00000X OPC6053 Florida

Profile Details

NPI number 1003243502
LBN Legal business name Basaly Demetrios, Romanda
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2013
Last updated Jul 19th, 2022 - about 2 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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