Healthcare Provider Details

I. General information

NPI: 1356280689
Provider Name (Legal Business Name): ROLINE JANVIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3306 N UNIVERSITY DR
SUNRISE FL
33351-6773
US

IV. Provider business mailing address

3306 N UNIVERSITY DR
SUNRISE FL
33351-6773
US

V. Phone/Fax

Practice location:
  • Phone: 954-331-5929
  • Fax: 954-572-3157
Mailing address:
  • Phone: 954-331-5929
  • Fax: 954-572-3157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberDO6753
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: