Provider Demographics
NPI:1598486078
Name:TURNER, DESTYNEE DIAMOND-ROSE (LDO)
Entity Type:Individual
Prefix:
First Name:DESTYNEE
Middle Name:DIAMOND-ROSE
Last Name:TURNER
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 1:218 LYMAN PL
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3708
Mailing Address - Country:US
Mailing Address - Phone:561-401-0902
Mailing Address - Fax:
Practice Address - Street 1:5601 CORPORATE WAY STE 117
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2041
Practice Address - Country:US
Practice Address - Phone:561-401-0902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6802156FC0800X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens