MEDICARE: NATALIYA A. WORSLEY, O.D., P.A.

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	OPC 3752	FL

General Provider Information

NPI Number	:	1396032645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATALIYA A. WORSLEY, O.D., P.A.

Provider Business Mailing Address
First Line	:	2551 E HALLANDALE BEACH BLVD
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4818
Country	:	US
Telephone Number	:	954-624-2165
Fax Number	:

Provider Business Practice Location Address
First Line	:	2551 E HALLANDALE BEACH BLVD
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4818
Country	:	US
Telephone Number	:	954-624-2165
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NATALIYA A. WORSLEY, O.D., P.A.
Credential	:	O.D., P.A.
Telephone Number	:	954-647-2617

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	11/09/2012

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