| |
1321 Nw 14th St, Suite 603, Miami, FL 33125-1673 | |
(305) 545-9393 | |
(305) 547-2393 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1321 Nw 14th St, Miami, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003846759 | NPI | - | NPPES |
274655700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPC2749 (Florida) | Secondary |
207W00000X | Ophthalmology | ME81887 (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
1321 Nw 14th St, Suite 603, Miami, FL 33125-1673 Ph: (305) 545-9393 | 1321 Nw 14th St, Suite 603, Miami, FL 33125-1673 Ph: (305) 545-9393 |