MEDICARE: ALEXANDRA SCHUETTE HOMANN 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	OEG002827	PA
2	152W00000X	Optometrist	OFC61	FL
3	152W00000X	Optometrist	2016005437	MO

General Provider Information

NPI Number	:	1114351921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA SCHUETTE HOMANN O.D.

Provider Business Mailing Address
First Line	:	3200 S UNIVERSITY DR
Second Line	:	TERRY BUILDING 1402
City	:	DAVIE
State	:	FL
Zip	:	33328-2018
Country	:	US
Telephone Number	:	954-262-1402
Fax Number	:	954-262-3217

Provider Business Practice Location Address
First Line	:	230 N LINDBERGH BLVD
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-5904
Country	:	US
Telephone Number	:	314-921-9377
Fax Number	:	314-921-9377

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

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	03/29/2019

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