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General NPI Number Information
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NPI Number | 1023330370
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Entity Type | Organization
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Legal Business Name | C. JUSTIN HOLCOMB, OD, LLC
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 5952 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-6814
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Country | US
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Telephone | 305-220-7555
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Fax | 786-534-8633
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Provider Business Mailing Address
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Address Line | 5952 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-6814
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Country | US
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Telephone | 305-220-7555
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Fax | 786-534-8633
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. CHRISTOPHER JUSTIN HOLCOMB
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Credential | OD
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Telephone | 305-785-1886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | OPC4902
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | OD60102641
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | OD60102641
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License Number State | WA
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