Healthcare Provider Details

I. General information

NPI: 1780699637
Provider Name (Legal Business Name): NOEMI ZUBIZARRETA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11735 SW 147TH AVE UNIT 16
MIAMI FL
33196-3330
US

IV. Provider business mailing address

11735 SW 147TH AVE UNIT 16
MIAMI FL
33196-3330
US

V. Phone/Fax

Practice location:
  • Phone: 786-953-8200
  • Fax: 786-953-8647
Mailing address:
  • Phone: 786-953-8200
  • Fax: 786-322-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC 4082
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: