Healthcare Provider Details

I. General information

NPI: 1851204606
Provider Name (Legal Business Name): PABLO ANICETO ALCOJOR SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1869 NW 20TH ST
MIAMI FL
33142-7431
US

IV. Provider business mailing address

1869 NW 20TH ST
MIAMI FL
33142-7431
US

V. Phone/Fax

Practice location:
  • Phone: 305-496-3943
  • Fax:
Mailing address:
  • Phone: 305-549-7333
  • Fax: 305-549-7339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberDO4033
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: