Cornish, Brandon William

Cornish, Brandon William is an sole proprietor health care provider with primary practice located at 640 N Federal Hwy , Fort Lauderdale FL 33304-4686. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cornish, Brandon William can be contacted via phone (954) 522-3918.

Contact Information

Primary practice address
640 N Federal Hwy Fort Lauderdale FL 33304-4686
Fax: (954) 522-5137
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC004217 Florida

Profile Details

NPI number 1396937470
LBN Legal business name Cornish, Brandon William
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 13th, 2007
Last updated Sep 10th, 2015 - about 9 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 1396937470 NPPES
Florida MEDICAID 6212671 00

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