Provider Demographics
NPI:1740352343
Name:NAIR, VIJAYAN (OD)
Entity type:Individual
Prefix:DR
First Name:VIJAYAN
Middle Name:
Last Name:NAIR
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 1:4620 ATWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-6495
Mailing Address - Country:US
Mailing Address - Phone:407-382-6011
Mailing Address - Fax:
Practice Address - Street 1:448 S ALAFAYA TRL
Practice Address - Street 2:SUITE 7
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8974
Practice Address - Country:US
Practice Address - Phone:407-382-6011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist