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General NPI Number Information
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NPI Number | 1730316514
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Entity Type | Organization
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Legal Business Name | JEEVANPRE K. JOWHAL, O.D., P.A.
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 19129 BISCAYNE BLVD
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City | AVENTURA
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State | FL
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Zip | 33180-2310
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Country | US
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Telephone | 305-792-4303
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Fax | 305-792-5803
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Provider Business Mailing Address
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Address Line | 19655 E COUNTRY CLUB DR #504
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City | AVENTURA
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State | FL
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Zip | 33180-4803
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Country | US
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Telephone | 305-467-4039
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEEVANPRE K. JOWHAL
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Credential | O.D.
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Telephone | 305-467-4039
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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 | OPC3479
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License Number State | FL
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