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General NPI Number Information
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NPI Number | 1972247864
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Entity Type | Individual
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Provider Name | KATARINA BUCKLEY OD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 03/16/2025
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Provider Practice Location Address
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Address Line | 5800 S UNIVERSITY DR
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City | DAVIE
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State | FL
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Zip | 33328-6102
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Country | US
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Telephone | 305-546-8928
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Fax |
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Provider Business Mailing Address
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Address Line | 17513 NW 87TH PL
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City | HIALEAH
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State | FL
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Zip | 33018-6610
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Country | US
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Telephone | 305-546-8928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPC6081
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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