MEDICARE: DR. SORAYA FRANCESCA KESHMIRI O.D.

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	2880	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164704664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SORAYA FRANCESCA KESHMIRI O.D.

Provider Business Mailing Address
First Line	:	1130 LAKE PLAZA DR STE 230
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3595
Country	:	US
Telephone Number	:	719-219-3819
Fax Number	:	719-219-0411

Provider Business Practice Location Address
First Line	:	1130 LAKE PLAZA DR STE 230
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3595
Country	:	US
Telephone Number	:	719-219-3819
Fax Number	:	719-219-0411

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

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	04/04/2013

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Directions to “ DR. SORAYA FRANCESCA KESHMIRI O.D.” Practice Location

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