MEDICARE: DR. LAURA ROZADA OD

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	OPC5613	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

General Provider Information

NPI Number	:	1568934438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA ROZADA OD

Provider Business Mailing Address
First Line	:	153 E 6TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4847
Country	:	US
Telephone Number	:	786-399-9614
Fax Number	:

Provider Business Practice Location Address
First Line	:	8060 NW 155TH ST STE 201
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5883
Country	:	US
Telephone Number	:	305-364-3737
Fax Number	:

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

Provider Enumeration Date	:	12/17/2018
Last Update Date	:	12/17/2018

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