MEDICARE: ANDREA JAE CARDA O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2506	IA
2	152W00000X	Optometrist	1361	NE

General Provider Information

NPI Number	:	1033340724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA JAE CARDA O.D.

Provider Business Mailing Address
First Line	:	2380 8TH AVE STE 4
Second Line	:
City	:	PLATTSMOUTH
State	:	NE
Zip	:	68048-2367
Country	:	US
Telephone Number	:	402-296-2200
Fax Number	:	402-296-6055

Provider Business Practice Location Address
First Line	:	2380 8TH AVE STE 4
Second Line	:
City	:	PLATTSMOUTH
State	:	NE
Zip	:	68048-2367
Country	:	US
Telephone Number	:	402-296-2200
Fax Number	:	402-296-6055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2009
Last Update Date	:	01/16/2024

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