Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARC JAY GANNON, O.D.
Deactivated Sole ProprietorDR. MARC JAY GANNON, O.D. is a Low Vision Rehabilitation Optometrist healthcare provider located in FT LAUDERDALE, Florida. NPI 1841286424 is deactivated in the NPPES registry. Verify at CMS.
Low Vision Rehabilitation Optometrist · FT LAUDERDALE, FL
This NPI has been deactivated.
The record was deactivated on March 24, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1841286424
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 20, 2005 (0.50684931506849 yrs)
- Last Updated
- Nov 27, 2007
- Deactivated
- Mar 24, 2006
- License
-
OPC001271 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2021 E COMMERCIAL BLVDSUITE #301FT LAUDERDALE, FL, 333083763Browse FL providers · Browse ZIP 33308
- Phone
- 9547765223
- Fax
- 9544910027
- Primary Specialty
-
Low Vision Rehabilitation Optometrist
152WL0500X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.