Provider Demographics
NPI:1215199468
Name:NORRIS, BETH ELISE (OD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ELISE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7326 LAKE UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-6055
Mailing Address - Country:US
Mailing Address - Phone:407-380-2020
Mailing Address - Fax:407-381-8112
Practice Address - Street 1:7326 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-6055
Practice Address - Country:US
Practice Address - Phone:407-380-2020
Practice Address - Fax:407-381-8112
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4465152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOPC4465OtherMEDICAL LICENSE
12027906OtherCAQH