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General NPI Number Information
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NPI Number | 1598061525
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Entity Type | Organization
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Legal Business Name | MICHAEL R. OBREGON, OD PA
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Dates
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Enumeration Date | 02/09/2011
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 2726 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-6005
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Country | US
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Telephone | 305-444-9600
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Fax | 305-444-9636
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Provider Business Mailing Address
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Address Line | 2726 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-6005
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Country | US
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Telephone | 305-444-9600
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Fax | 305-444-9636
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL R. OBREGON
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Credential | O.D.
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Telephone | 305-527-0098
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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 | FL 2089
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License Number State | FL
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