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General NPI Number Information
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NPI Number | 1043924004
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Entity Type | Organization
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Legal Business Name | TWENTY20 VISION CENTER LLC
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 5601 NW 183RD ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-2305
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Country | US
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Telephone | 305-760-7008
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Fax |
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Provider Business Mailing Address
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Address Line | 4423 SW 176TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33029-5268
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Country | US
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Telephone | 954-805-1443
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | DR. SAHAR ELTALLA
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Credential | OD
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Telephone | 954-805-1443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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