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NPI Code Detail

MEDICARE: JENNIFER BAUZA, OD PA

MEDICARE: JENNIFER BAUZA, OD PA
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
1152W00000XOptometristOPC 4423FL

General Provider Information

NPI Number : 1134443997
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIFER BAUZA, OD PA
Provider Business Mailing Address
First Line : 5231 W 25TH CT
Second Line :
City : HIALEAH
State : FL
Zip : 33016-4072
Country : US
Telephone Number : 786-333-3338
Fax Number :
Provider Business Practice Location Address
First Line : 5231 W 25TH CT
Second Line :
City : HIALEAH
State : FL
Zip : 33016-4072
Country : US
Telephone Number : 786-333-3338
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JENNIFER BAUZA
Credential : O.D.
Telephone Number : 786-333-3338
Provider Enumeration Date : 03/23/2010
Last Update Date : 03/08/2011

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Directions to “JENNIFER BAUZA, OD PA ” Practice Location

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