Healthcare Provider Details
I. General information
NPI: 1962904227
Provider Name (Legal Business Name): SIDNEY J STERN VISUAL HEALTH CENTERS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16853 NE 2ND AVE STE 201
NORTH MIAMI BEACH FL
33162-1776
US
IV. Provider business mailing address
7352 NW 34TH ST
MIAMI FL
33122-1266
US
V. Phone/Fax
- Phone: 305-654-8810
- Fax: 305-654-8839
- Phone: 305-418-2025
- Fax: 305-418-6768
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SIDNEY
J
STERN
Title or Position: PRESIDENT
Credential: OD
Phone: 305-418-2025