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General NPI Number Information
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NPI Number | 1427254978
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Entity Type | Organization
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Legal Business Name | LANDSAW O D P A
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 91284 OVERSEAS HWY
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City | TAVERNIER
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State | FL
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Zip | 33070-2555
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Country | US
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Telephone | 305-853-3153
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Fax | 305-853-3152
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Provider Business Mailing Address
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Address Line | 91284 OVERSEAS HWY
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City | TAVERNIER
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State | FL
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Zip | 33070-2555
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Country | US
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Telephone | 305-853-3153
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Fax | 305-853-3152
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JANNAH MILLER LANDSAW
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Credential | O.D.
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Telephone | 305-853-3153
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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 |
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License Number State | FL
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