Ilab1, LLC

NPI #1053891556 in Orlando, Florida

Provider Information

NPI Number: 1053891556
Entity Type: Organization
Organization Name: Ilab1, LLC
Primary Specialty: Optometrist
Enumeration Date: Aug 15, 2018
Last Updated: Aug 15, 2018

Practice Location

Address: 3016 E COLONIAL DR
City: Orlando
State: Florida
ZIP Code: 32803-5006
Phone: (561) 275-2020

Authorized Official

Name: JACKIE BENNETT
Title: CREDENTIALING MANAGER
Phone: (561) 612-4531

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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