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General NPI Number Information
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NPI Number | 1881048247
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Entity Type | Organization
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Legal Business Name | LOH OPHTHALMOLOGY ASSOCIATES
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 6705 S RED RD SUITE 514
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-3622
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Country | US
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Telephone | 305-602-3040
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Fax | 305-602-3010
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Provider Business Mailing Address
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Address Line | 6705 S RED RD SUITE 514
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-3622
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Country | US
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Telephone | 305-602-3040
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Fax | 305-602-3010
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER LOH
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Credential | MD
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Telephone | 317-440-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME110442
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License Number State | FL
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