Healthcare Provider Details

I. General information

NPI: 1336092097
Provider Name (Legal Business Name): ADRIANA MIYUKI SASSAKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 UNIVERSITY BLVD
BIRMINGHAM AL
35233-1816
US

IV. Provider business mailing address

1720 UNIVERSITY BLVD STE 305
BIRMINGHAM AL
35233-1816
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8100
  • Fax: 205-325-8654
Mailing address:
  • Phone: 205-325-8620
  • Fax: 205-325-8654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberL.6866
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: