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General NPI Number Information
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NPI Number | 1184594830
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Entity Type | Organization
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Legal Business Name | KD ESTABLISHMENTS
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 17650 NW 2ND AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-5019
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Country | US
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Telephone | 305-645-7542
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Fax |
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Provider Business Mailing Address
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Address Line | 2399 NW 167TH ST APT 507
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4582
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Country | US
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Telephone | 518-334-0477
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | KIZITO CEDRIC DENNIS
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Credential | OD
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Telephone | 518-334-0477
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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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