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General NPI Number Information
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NPI Number | 1427188218
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Entity Type | Individual
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Provider Name | ANDREW JOSHUA JENSEN O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 9080 KIMBERLY BLVD STE #11
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City | BOCA RATON
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State | FL
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Zip | 33434-2862
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Country | US
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Telephone | 561-488-6200
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Fax | 561-488-0714
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Provider Business Mailing Address
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Address Line | 9080 KIMBERLY BLVD STE #11
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City | BOCA RATON
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State | FL
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Zip | 33434-2862
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Country | US
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Telephone | 561-488-6200
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Fax | 561-488-0714
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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 | 2682
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License Number State | TN
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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 | OPC4228
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License Number State | FL
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