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General NPI Number Information
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NPI Number | 1538231626
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Entity Type | Individual
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Provider Name | MISSBA BAWANEY O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 8990 TURKEY LAKE ROAD MB EYECARE, LLC
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 847-677-7202
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Fax | 847-677-1258
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Provider Business Mailing Address
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Address Line | MB EYECARE, LLC 8990 TURKEY LAKE ROAD
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone |
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Fax |
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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 | 46009886
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License Number State | IL
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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 | 046009886
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4197
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License Number State | FL
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