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General NPI Number Information
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NPI Number | 1538299201
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Entity Type | Individual
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Provider Name | MIRIAM TENDLER EVANS OD
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 10/23/2009
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Provider Practice Location Address
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Address Line | 1375 N STATE ROAD 7
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City | LAUDERHILL
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State | FL
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Zip | 33313-5884
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Country | US
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Telephone | 954-641-3777
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Fax | 954-792-7428
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Provider Business Mailing Address
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Address Line | 20780 SNUG CREEK CT
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City | BOCA RATON
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State | FL
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Zip | 33498-6824
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Country | US
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Telephone | 561-852-9190
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Fax | 561-852-9190
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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 | 2666
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License Number State | FL
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