Healthcare Provider Details

I. General information

NPI: 1619682291
Provider Name (Legal Business Name): DANA L. GAMPEL, OD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3542 CORAL WAY # 44
MIAMI FL
33145-3013
US

IV. Provider business mailing address

315 NE 3RD AVE APT 1907
FORT LAUDERDALE FL
33301-1685
US

V. Phone/Fax

Practice location:
  • Phone: 305-441-1717
  • Fax: 305-441-0543
Mailing address:
  • Phone: 954-647-3193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DANA GAMPEL
Title or Position: OWNER
Credential: OD
Phone: 954-647-3193