MEDICARE: DR. J. CARL CEMBRANO 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	6336T	TX

General Provider Information

NPI Number	:	1912991571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. J. CARL CEMBRANO O.D.

Provider Business Mailing Address
First Line	:	PSC 41 BOX 394
Second Line	:
City	:	APO
State	:	AE
Zip	:	09464
Country	:	GB
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIT 5210, BOX 230
Second Line	:
City	:	APO
State	:	AE
Zip	:	09461
Country	:	GB
Telephone Number	:	441638529213
Fax Number	:

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

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	07/21/2022

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