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General NPI Number Information
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NPI Number | 1750752937
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Entity Type | Organization
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Legal Business Name | MARLYNE ALCINOR OD PA
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 5004 SW 155TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33027-5633
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Country | US
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Telephone | 786-543-2713
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Fax |
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Provider Business Mailing Address
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Address Line | 5004 SW 155TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33027-5633
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Country | US
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Telephone | 786-543-2713
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARLYNE ALCINOR
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Credential | OD
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Telephone | 786-543-2713
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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 | OPC4508
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License Number State | FL
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