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General NPI Number Information
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NPI Number | 1245594753
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Entity Type | Organization
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Legal Business Name | MARIA M CASAS OD INC
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 1455 NW 107TH AVE SUITE 790
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City | DORAL
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State | FL
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Zip | 33172-2711
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Country | US
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Telephone | 305-477-0534
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Fax | 305-591-3589
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Provider Business Mailing Address
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Address Line | 1455 NW 107TH AVE SUITE 790
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City | DORAL
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State | FL
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Zip | 33172-2711
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Country | US
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Telephone | 305-477-0534
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Fax | 305-591-3589
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA CASAS
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Credential | OD
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Telephone | 305-477-0534
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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 | FL2470
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License Number State | FL
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