Healthcare Provider Details

I. General information

NPI: 1437347499
Provider Name (Legal Business Name): ISABEL MADOLYN CARVAJAL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5976 CORAL RIDGE DR
CORAL SPRINGS FL
33076-3302
US

IV. Provider business mailing address

5976 CORAL RIDGE DR
CORAL SPRINGS FL
33076-3302
US

V. Phone/Fax

Practice location:
  • Phone: 954-227-7488
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC4213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: