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General NPI Number Information
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NPI Number | 1619246295
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Entity Type | Organization
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Legal Business Name | ANASTASIA JOBSON PA
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Dates
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Enumeration Date | 12/28/2011
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 3001 N STATE ROAD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-1913
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Country | US
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Telephone | 954-497-0846
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Fax | 954-733-2879
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Provider Business Mailing Address
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Address Line | 955 NW 100TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-4372
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Country | US
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Telephone | 954-558-0770
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Fax | 954-733-2879
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Authorized Official
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Title or Position | OWNER/OFFICER
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Name | DR. ANASTASIA C JOBSON
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Credential | OD
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Telephone | 954-497-0846
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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 | OPC3904
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License Number State | FL
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