Provider Demographics
NPI:1225728652
Name:CHAMBERS, LITA (LDO)
Entity Type:Individual
Prefix:MISS
First Name:LITA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-2655
Mailing Address - Country:US
Mailing Address - Phone:954-681-7530
Mailing Address - Fax:954-971-6387
Practice Address - Street 1:2300 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-2655
Practice Address - Country:US
Practice Address - Phone:954-971-6170
Practice Address - Fax:954-971-6387
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4801156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician