MEDICARE: MR. HANS AZEMARD DO

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	156FX1800X	Optician	DO4804	FL

General Provider Information

NPI Number	:	1285125377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HANS AZEMARD DO

Provider Business Mailing Address
First Line	:	6600 NW 70TH AVE
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-5569
Country	:	US
Telephone Number	:	305-303-9872
Fax Number	:

Provider Business Practice Location Address
First Line	:	8030 W MCNAB RD
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4226
Country	:	US
Telephone Number	:	305-303-9872
Fax Number	:

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

Provider Enumeration Date	:	05/23/2018
Last Update Date	:	05/23/2018

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