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General NPI Number Information
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NPI Number | 1942550231
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Entity Type | Organization
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Legal Business Name | ELIZABETH M BORZA OD INC
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 03/21/2013
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Provider Practice Location Address
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Address Line | 2201 UPTON DR 902
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-1292
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Country | US
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Telephone | 757-430-2863
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Fax | 757-430-2865
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Provider Business Mailing Address
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Address Line | 2201 UPTON DR 902
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-1292
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Country | US
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Telephone | 757-430-2863
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Fax | 757-430-2865
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH BORZA
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Credential | OD
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Telephone | 757-430-2863
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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 | 0618002034
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License Number State | VA
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