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General NPI Number Information
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NPI Number | 1942475173
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Entity Type | Organization
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Legal Business Name | DR STEVEN M TUCKER PA
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 9950 GRIFFIN ROAD
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City | COOPER CITY
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State | FL
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Zip | 33328-3420
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Country | US
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Telephone | 954-434-5500
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Fax | 954-434-5501
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Provider Business Mailing Address
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Address Line | 9950 GRIFFIN ROAD
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City | COOPER CITY
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State | FL
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Zip | 33328-3420
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Country | US
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Telephone | 954-434-5500
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Fax | 954-434-5501
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Authorized Official
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Title or Position | OWNER OPTOMETRIST
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Name | DR. STEVEN MICHAEL TUCKER
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Credential | OD
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Telephone | 954-434-5500
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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 | OPC1120
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License Number State | FL
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