Lilly, Mary Susan
Lilly, Mary Susan is an sole proprietor health care provider with primary practice located at 3875 Us Highway 301 S , Riverview FL 33578. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Lilly, Mary Susan can be contacted via phone (813) 246-3186.Contact Information
Primary practice address
3875 Us Highway 301 S
Riverview FL 33578
Phone: (813) 246-3186
Fax: (813) 542-2246
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC 3537 | Florida |
Profile Details
| NPI number | 1003907650 |
|---|---|
| LBN Legal business name | Lilly, Mary Susan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2006 |
| Last updated | May 22nd, 2018 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003907650 | NPPES |
| Florida | MEDICAID | 6205704 00 |
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