MEDICARE: DR. SO YEON TSE O.D., FAAO

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	OPC6693	FL
2	152W00000X	Optometrist	OPFC68	FL

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	:	1518093160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SO YEON TSE O.D., FAAO

Provider Business Mailing Address
First Line	:	3200 S UNIVERSITY DR
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-2018
Country	:	US
Telephone Number	:	954-262-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 S. UNIVERSITY DRIVE
Second Line	:
City	:	FT. LAUDERDALE
State	:	FL
Zip	:	33328-2018
Country	:	US
Telephone Number	:	954-262-4200
Fax Number	:

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	06/20/2025

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