Healthcare Provider Details

I. General information

NPI: 1780516708
Provider Name (Legal Business Name): JULIET HASSAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NW 17TH ST
MIAMI FL
33136-1119
US

IV. Provider business mailing address

13968 LAKE LURE CT
MIAMI LAKES FL
33014-3049
US

V. Phone/Fax

Practice location:
  • Phone: 305-326-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: