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General NPI Number Information
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NPI Number | 1265631022
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Entity Type | Organization
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Legal Business Name | CARLA PARIS TEICH O D P L
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 12/01/2012
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Provider Practice Location Address
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Address Line | 5794 NW 48TH DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4015
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Country | US
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Telephone | 954-445-7764
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Fax |
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Provider Business Mailing Address
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Address Line | 5794 NW 48TH DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4015
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Country | US
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Telephone | 954-445-7764
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST SOLE PROPRIETOR
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Name | DR. CARLA PARIS TEICH
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Credential | O D
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Telephone | 954-445-7764
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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 | OPC1744
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License Number State | FL
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