Healthcare Provider Details

I. General information

NPI: 1639660731
Provider Name (Legal Business Name): DAYONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8030 W MCNAB RD
NORTH LAUDERDALE FL
33068-4226
US

IV. Provider business mailing address

6600 NW 70TH AVE
TAMARAC FL
33321-5569
US

V. Phone/Fax

Practice location:
  • Phone: 305-303-9872
  • Fax:
Mailing address:
  • Phone: 305-303-9872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberDO4804
License Number StateFL

VIII. Authorized Official

Name: MR. HANS AZEMARD
Title or Position: PRESIDENT
Credential: DO
Phone: 305-303-9872