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NPI Code Detail

MEDICARE: DR. WAFA ABDULRAZZAQ OD

MEDICARE: DR. WAFA ABDULRAZZAQ OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3982FL

General Provider Information

NPI Number : 1063623858
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WAFA ABDULRAZZAQ OD
Provider Business Mailing Address
First Line : 8711 STIRLING RD
Second Line :
City : COOPER CITY
State : FL
Zip : 33328-5932
Country : US
Telephone Number : 954-434-1414
Fax Number : 954-434-1417
Provider Business Practice Location Address
First Line : 8711 STIRLING RD
Second Line :
City : COOPER CITY
State : FL
Zip : 33328-5932
Country : US
Telephone Number : 954-434-1414
Fax Number : 954-434-1417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2007
Last Update Date : 06/22/2011

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Directions to “ DR. WAFA ABDULRAZZAQ OD” Practice Location

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