Healthcare Provider Details

I. General information

NPI: 1023583564
Provider Name (Legal Business Name): ROCHESTER OPHTHALMOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 W UNIVERSITY DR STE 155
ROCHESTER MI
48307-1871
US

IV. Provider business mailing address

839 CRISPIN
ROCHESTER HILLS MI
48307-2467
US

V. Phone/Fax

Practice location:
  • Phone: 734-277-1578
  • Fax:
Mailing address:
  • Phone: 734-277-1578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA VRABEC
Title or Position: SOLE MEMBER
Credential: MD
Phone: 734-277-1578