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General NPI Number Information
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NPI Number | 1184169021
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Entity Type | Organization
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Legal Business Name | OC EYECARE LLC
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 9549 NW 41ST ST
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City | DORAL
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State | FL
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Zip | 33178-2371
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Country | US
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Telephone | 305-591-6566
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Fax | 786-462-2352
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Provider Business Mailing Address
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Address Line | 666 W 65TH DR
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City | HIALEAH
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State | FL
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Zip | 33012-6561
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Country | US
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Telephone | 305-917-3269
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. OSVALDO CABRERA
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Credential | OD
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Telephone | 305-917-3269
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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 | OPC 5195
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License Number State | FL
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