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General NPI Number Information
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NPI Number | 1073881363
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Entity Type | Organization
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Legal Business Name | EDWARD L BUDD OD DOCTOR OF OPTOMETRY, PA
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 377 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-6057
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Country | US
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Telephone | 305-247-3227
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Fax | 305-248-4107
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Provider Business Mailing Address
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Address Line | 377 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-6057
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Country | US
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Telephone | 305-247-3227
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Fax | 305-248-4107
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD LAWRENCE BUDD
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Credential | OD
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Telephone | 305-247-3227
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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 | OPC3218
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License Number State | FL
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