Provider Demographics
NPI:1730339177
Name:HLIS, MARK J (OD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:HLIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:106 NAUTILUS DR
Mailing Address - Street 2:
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036-4207
Mailing Address - Country:US
Mailing Address - Phone:305-664-2665
Mailing Address - Fax:
Practice Address - Street 1:81933 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-3607
Practice Address - Country:US
Practice Address - Phone:305-664-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOCP2364152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist