Broome, Kevin Andrew

Broome, Kevin Andrew is an individual health care provider with primary practice located at 701 S Ridgewood Ave , Daytona Beach FL 32114-5331. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Broome, Kevin Andrew can be contacted via phone (386) 253-5999.

Contact Information

Primary practice address
701 S Ridgewood Ave Daytona Beach FL 32114-5331
Phone: (386) 253-5999
Fax: (386) 253-1193
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X OPC3301 Florida
Eye and Vision Services Providers / Optometrist 152W00000X OPC3301 Florida

Profile Details

NPI number 1548296486
LBN Legal business name Broome, Kevin Andrew
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Apr 12th, 2018 - about 6 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 1548296486 NPPES
Florida MEDICAID 620421000

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