Provider Demographics
NPI:1639328750
Name:NODLAND, MICHAEL J (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:NODLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 S FLAGLER DR
Mailing Address - Street 2:1030
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7154
Mailing Address - Country:US
Mailing Address - Phone:561-784-2778
Mailing Address - Fax:561-798-9409
Practice Address - Street 1:10155 OKEECHOBEE BLVD
Practice Address - Street 2:OPTICAL
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1404
Practice Address - Country:US
Practice Address - Phone:561-784-2778
Practice Address - Fax:561-798-9409
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4365152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist