Healthcare Provider Details

I. General information

NPI: 1366649618
Provider Name (Legal Business Name): DR. STEPHEN HOUGHTON PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 06/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12640 NORTH KENDALL DRIVE
MIAMI FL
33186
US

IV. Provider business mailing address

9569 SOUTH DIXIE HWY.
MIAMI FL
33156
US

V. Phone/Fax

Practice location:
  • Phone: 305-273-7790
  • Fax: 305-273-8018
Mailing address:
  • Phone: 305-665-3279
  • Fax: 305-661-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC1156
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN HOUGHTON
Title or Position: OWNER
Credential: O.D.
Phone: 305-665-3279