Provider Demographics
NPI:1659722874
Name:CHIARAMONTI, ALYCIA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALYCIA
Middle Name:ANN
Last Name:CHIARAMONTI
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 1:10601 US HIGHWAY 441
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-7237
Mailing Address - Country:US
Mailing Address - Phone:352-360-0051
Mailing Address - Fax:
Practice Address - Street 1:10601 US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-7237
Practice Address - Country:US
Practice Address - Phone:352-360-0051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5205152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist