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Contact Information

THERESE B DAHL, OD
3659 SOUTH HOPKINS AVE
SUITE D
TITUSVILLE, FL32780
 Phone: 321-264-4264
 Fax: 321-264-9433
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for THERESE B DAHL · (Female)

NPI Number 1992878771
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 11/17/2006
Last updated 02/04/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • FL License # OPL1525
  • WI License # 1532
  • FL Medicaid 078593800
  • Other 27596 AVESIS
  • Other 1213330001 DMNS CLEARING HOUSE
  • Other 114116 EYEMED
  • Other 180004904 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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