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General NPI Number Information
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NPI Number | 1275939100
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Entity Type | Individual
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Provider Name | JOSEPH A KESSELMAN O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 11605 PINES BLVD LENSCRAFTERS AT MACY'S
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City | PEMBROKE PINES
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State | FL
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Zip | 33026
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Country | US
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Telephone | 954-438-2427
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Fax | 305-850-3801
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Provider Business Mailing Address
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Address Line | 11605 PINES BLVD LENSCRAFTERS AT MACY'S
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City | PEMBROKE PINES
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State | FL
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Zip | 33026
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Country | US
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Telephone | 305-850-3800
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Fax | 305-850-3801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OEG002967
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4993
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License Number State | FL
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