MEDICARE: CARLA PARIS TEICH O D P L

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	OPC1744	FL

General Provider Information

NPI Number	:	1265631022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLA PARIS TEICH O D P L

Provider Business Mailing Address
First Line	:	5794 NW 48TH DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4015
Country	:	US
Telephone Number	:	954-445-7764
Fax Number	:

Provider Business Practice Location Address
First Line	:	5794 NW 48TH DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4015
Country	:	US
Telephone Number	:	954-445-7764
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST SOLE PROPRIETOR
Name	:	DR. CARLA PARIS TEICH
Credential	:	O D
Telephone Number	:	954-445-7764

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	12/01/2012

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