MEDICARE: DR. ELORA ROBBANI 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
1	152W00000X	Optometrist	OPT003312	GA

General Provider Information

NPI Number	:	1134941743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELORA ROBBANI OD

Provider Business Mailing Address
First Line	:	722 COSMOPOLITAN DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3615
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	722 COSMOPOLITAN DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3615
Country	:	US
Telephone Number	:	256-479-3282
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2024
Last Update Date	:	10/26/2024

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