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General NPI Number Information
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NPI Number | 1457904765
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Entity Type | Individual
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Provider Name | MELISSA OTERO OD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2019
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 4330 SHERIDAN ST STE 102B
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City | HOLLYWOOD
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State | FL
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Zip | 33021-1407
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Country | US
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Telephone | 954-287-2010
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Fax | 305-723-1910
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Provider Business Mailing Address
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Address Line | 4330 SHERIDAN ST # 102-B
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City | HOLLYWOOD
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State | FL
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Zip | 33021-1407
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Country | US
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Telephone | 954-287-2010
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Fax | 305-723-1910
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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 | OPC5671
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License Number State | FL
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