Healthcare Provider Details

I. General information

NPI: 1275790263
Provider Name (Legal Business Name): FLORIDA OPTOMETRIC PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7352 NW 34TH ST
MIAMI FL
33122-1266
US

IV. Provider business mailing address

7352 NW 34TH ST
MIAMI FL
33122-1266
US

V. Phone/Fax

Practice location:
  • Phone: 305-418-2025
  • Fax: 305-418-9882
Mailing address:
  • Phone: 305-418-2025
  • Fax: 305-418-9882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MS. YVETTE MUNOZ
Title or Position: BILLING/CREDENTIALING
Credential:
Phone: 305-418-2025