Healthcare Provider Details

I. General information

NPI: 1144147992
Provider Name (Legal Business Name): ANA BARBARA REYES BOUZA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 S UNIVERSITY DR
FT LAUDERDALE FL
33328-2004
US

IV. Provider business mailing address

3300 S UNIVERSITY DR
FT LAUDERDALE FL
33328-2004
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-4235
  • Fax:
Mailing address:
  • Phone: 954-262-4235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11727TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: