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General NPI Number Information
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NPI Number | 1689902272
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Entity Type | Organization
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Legal Business Name | DAMIAN LUE, O.D., P.A.
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 5851 NW 177TH ST
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City | HIALEAH
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State | FL
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Zip | 33015-5127
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Country | US
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Telephone | 305-558-4326
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Fax | 305-826-2841
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Provider Business Mailing Address
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Address Line | 5851 NW 177TH ST
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City | HIALEAH
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State | FL
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Zip | 33015-5127
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Country | US
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Telephone | 305-558-4326
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Fax | 305-826-2841
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAMIAN FRANCIS LUE
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Credential | O.D.
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Telephone | 305-558-4326
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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 | OPC3021
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License Number State | FL
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