Dr Khai Gia Phan, OD | |
19501 Nw 27th Ave, Miami Gardens, FL 33056-2521 | |
(305) 974-2588 | |
Not Available |
Full Name | Dr Khai Gia Phan |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 19501 Nw 27th Ave, Miami Gardens, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417077710 | NPI | - | NPPES |
014191100 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPC3501 (Florida) | Primary |
Provider Name | Myeyedr Optometry Of Florida, Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1073907028 PECOS PAC ID: 0143541037 Enrollment ID: O20150603002802 |
Mailing Address | Practice Location Address |
---|---|
Dr Khai Gia Phan, OD 19501 Nw 27th Ave, Miami Gardens, FL 33056-2521 Ph: (305) 974-2588 | Dr Khai Gia Phan, OD 19501 Nw 27th Ave, Miami Gardens, FL 33056-2521 Ph: (305) 974-2588 |
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