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General NPI Number Information
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NPI Number | 1649300724
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Entity Type | Individual
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Provider Name | LENWARD MCCALLA O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11417 S DIXIE HWY
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City | MIAMI
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State | FL
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Zip | 33156-4443
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Country | US
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Telephone | 305-378-1915
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Fax | 305-256-6919
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Provider Business Mailing Address
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Address Line | 15141 SW 159TH ST
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City | MIAMI
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State | FL
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Zip | 33187-6601
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Country | US
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Telephone | 305-378-1915
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Fax | 305-256-6919
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 2077
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License Number State | FL
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