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General NPI Number Information
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NPI Number | 1417250374
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Entity Type | Organization
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Legal Business Name | LISA E NADEL OD PA
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 6518 N STATE ROAD 7
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City | COCONUT CREEK
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State | FL
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Zip | 33073-3623
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Country | US
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Telephone | 954-426-4944
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Fax | 954-426-3109
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Provider Business Mailing Address
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Address Line | 6518 N STATE ROAD 7
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City | COCONUT CREEK
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State | FL
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Zip | 33073-3623
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Country | US
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Telephone | 954-426-4944
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Fax | 954-426-3109
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Authorized Official
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Title or Position | OWNER
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Name | MR. LISA NADEL
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Credential |
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Telephone | 954-426-4944
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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 | OPC2624
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License Number State | FL
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