MEDICARE: DR. BRIAN ASALONE 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	OPC 3680	FL

General Provider Information

NPI Number	:	1417145400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ASALONE O.D.

Provider Business Mailing Address
First Line	:	2301 NE 9TH AVE
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33305-2266
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2583 E SUNRISE BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3203
Country	:	US
Telephone Number	:	954-563-8288
Fax Number	:

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

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	10/03/2024

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