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NPI Code Detail

MEDICARE: DR. ANDREW JOSEPH CIAMBRONE OD

MEDICARE: DR. ANDREW JOSEPH CIAMBRONE 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
1152W00000XOptometristOPC003324FL

General Provider Information

NPI Number : 1487645974
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW JOSEPH CIAMBRONE OD
Provider Business Mailing Address
First Line : 3841 STRAFFORD PL
Second Line :
City : LAKELAND
State : FL
Zip : 33810-2471
Country : US
Telephone Number : 863-670-0109
Fax Number : 407-397-9231
Provider Business Practice Location Address
First Line : 4444 W VINE ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-5315
Country : US
Telephone Number : 407-390-0585
Fax Number : 407-397-9231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 01/10/2011

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