Provider Demographics
NPI:1699470542
Name:LOVETT, VERONIKA DANIELLE (RDMS, RVT)
Entity type:Individual
Prefix:
First Name:VERONIKA
Middle Name:DANIELLE
Last Name:LOVETT
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 KNOXVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-3770
Mailing Address - Country:US
Mailing Address - Phone:757-513-8923
Mailing Address - Fax:
Practice Address - Street 1:4325 KNOXVILLE AVE
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-3770
Practice Address - Country:US
Practice Address - Phone:757-513-8923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR920897156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist