Provider Demographics
NPI:1740416718
Name:WILLIAM E RIEHL JR OD PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:WILLIAM E RIEHL JR OD PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEHL
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:954-557-6823
Mailing Address - Street 1:2532 N HIGHWAY A1A
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-2300
Mailing Address - Country:US
Mailing Address - Phone:954-557-6823
Mailing Address - Fax:
Practice Address - Street 1:6200 20TH ST
Practice Address - Street 2:ROOM 850
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-1012
Practice Address - Country:US
Practice Address - Phone:772-567-9142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1959152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty