MEDICARE: DR. MICHAEL B HAUGEN 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	OPC 2181	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	:	1902896558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL B HAUGEN OD

Provider Business Mailing Address
First Line	:	11380 PROSPERITY FARMS RD
Second Line	:	SUITE 119
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3464
Country	:	US
Telephone Number	:	561-627-1114
Fax Number	:	561-627-2304

Provider Business Practice Location Address
First Line	:	11380 PROSPERITY FARMS RD
Second Line	:	SUITE 119
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3464
Country	:	US
Telephone Number	:	561-627-1114
Fax Number	:	561-627-2304

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	04/07/2015

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