L BRUCE FOSEN OD PA
Optometry at 28 St, Ocala, FL

License number
Florida OPC 887
Category
Optometry
Type
Optometrist
Owner
Name: DR. LLOYD BRUCE FOSEN O D
Title: PRESIDENT
Phone: (352) 208-0091
Address
Address
2535 SE 28Th St, Ocala, FL 34471
National Provider ID: 1770764920
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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L. BRUCE FOSEN O.D., PA

Crystal River, FL  -  Ocala, FL

Status:
Inactive
Industry:
Optometrist's Office
Inactive reason:
Admin Dissolution For Annual Report
Registration:
Jun 22, 1990
Inactive since:
Sep 26, 2014
Addresses:
631 N Citrus Ave SUITE C, Crystal River, FL 34428 (Physical)
2535 SE 28 St, Ocala, FL 34471 (Mailing)
State ID:
L82987
Business type:
Florida Profit Corporation
Directors:
Lloyd B Fosen President, Secretary, inactive, 2535 SE 28 St, Ocala, FL 34471 (Physical),Fosen L. Bruce Director, inactive
Agent:
Lloyd Fosen,2535 SE 28 St, Ocala, FL 34471 (Physical)
EIN:
593013283

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