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General NPI Number Information
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NPI Number | 1346518875
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Entity Type | Organization
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Legal Business Name | LUCY BENARD OD PA
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Dates
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Enumeration Date | 12/12/2011
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 13600 SW 288TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-1905
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Country | US
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Telephone | 305-248-8883
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Fax | 844-814-2970
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Provider Business Mailing Address
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Address Line | 14974 SW 11TH ST
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City | MIAMI
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State | FL
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Zip | 33194-2505
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Country | US
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Telephone | 786-999-4205
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUCY JEANETTE BENARD-ZELEDON
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Credential | O.D.
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Telephone | 786-999-4205
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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 3685
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License Number State | FL
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