NPI 1003243502

Romanda Basaly Demetrios, OD

Practitioner Optometrist Saint Johns, FL

Practice location

Address: 155 Fountains Way STE 11, Saint Johns, FL 32259-1144
Phone: (404) 932-2802
Mailing address: 133 Rum Runner Way, Saint Johns, FL 32259-2267

Registered specialties (3)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence OPC6053 (FL)

Other Optometrist providers in Florida →

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence 4901004806 (MI)

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence OPT002962 (GA)

Registry record

NPI: 1003243502
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Sep 2013
Record last updated: 19 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.