MEDICARE: DR. SHELDON H. KREDA 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	OPC001423	FL
2	152WC0802X	Corneal and Contact Management Optometrist	OPC001423	FL
3	152WL0500X	Low Vision Rehabilitation Optometrist	OPC001423	FL
4	152WP0200X	Pediatric Optometrist	OPC001423	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205826138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELDON H. KREDA O.D.

Provider Business Mailing Address
First Line	:	7020 W COMMERCIAL BLVD
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-2122
Country	:	US
Telephone Number	:	954-749-0000
Fax Number	:	954-742-3492

Provider Business Practice Location Address
First Line	:	7020 W COMMERCIAL BLVD
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-2122
Country	:	US
Telephone Number	:	954-749-0000
Fax Number	:	954-742-3492

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

Provider Enumeration Date	:	10/22/2005
Last Update Date	:	08/30/2010

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Directions to “ DR. SHELDON H. KREDA O.D.” Practice Location

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