Provider Demographics
NPI:1679356786
Name:MARSID, AMIRA (OD)
Entity type:Individual
Prefix:
First Name:AMIRA
Middle Name:
Last Name:MARSID
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 1:1911 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1407
Mailing Address - Country:US
Mailing Address - Phone:407-893-8200
Mailing Address - Fax:
Practice Address - Street 1:1911 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1407
Practice Address - Country:US
Practice Address - Phone:407-893-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003527152W00000X
FLOPC6355152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist