Provider Demographics
NPI:1336845353
Name:LABOSSIERE, EVELYNE DALHIA
Entity Type:Individual
Prefix:
First Name:EVELYNE
Middle Name:DALHIA
Last Name:LABOSSIERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 COLLIER BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-8125
Mailing Address - Country:US
Mailing Address - Phone:239-417-2251
Mailing Address - Fax:239-417-2291
Practice Address - Street 1:6650 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-8125
Practice Address - Country:US
Practice Address - Phone:239-417-2251
Practice Address - Fax:239-417-2291
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician