Healthcare Provider Details

I. General information

NPI: 1689697021
Provider Name (Legal Business Name): AHAVA OPPENHEIMER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7263 ATLANTIC AVE
DELRAY BEACH FL
33446-1305
US

IV. Provider business mailing address

22360 GUADELOUPE ST
BOCA RATON FL
33433-4939
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-2020
  • Fax: 561-496-3846
Mailing address:
  • Phone:
  • Fax: 561-496-3846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC3820
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberDA2274
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV006666
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: