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General NPI Number Information
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NPI Number | 1649443789
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Entity Type | Individual
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Provider Name | GIDDEL A ROUVIER LDO
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Gender | Male
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 3401 N MIAMI AVE STE 114
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City | MIAMI
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State | FL
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Zip | 33127-3527
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Country | US
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Telephone | 305-576-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 816 NW 11TH ST APT 801
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City | MIAMI
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State | FL
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Zip | 33136-3121
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Country | US
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Telephone | 786-356-3461
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | DO 5634
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License Number State | FL
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