Healthcare Provider Details

I. General information

NPI: 1700401486
Provider Name (Legal Business Name): ASEEYA INSHAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9428 W COLONIAL DR
OCOEE FL
34761-6800
US

IV. Provider business mailing address

1943 POMEGRANATE CT
OCOEE FL
34761-7699
US

V. Phone/Fax

Practice location:
  • Phone: 407-291-1921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC5796
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: