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NPI Code Detail

MEDICARE: DR. CAROLINE VOLLBERG MISCH OD

MEDICARE: DR. CAROLINE VOLLBERG MISCH 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
1152W00000XOptometrist3618TN
2152W00000XOptometristOPC6637FL

Other Identifiers

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

General Provider Information

NPI Number : 1619585130
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROLINE VOLLBERG MISCH OD
Provider Business Mailing Address
First Line : PO BOX 201638
Second Line :
City : DALLAS
State : TX
Zip : 75320-1638
Country : US
Telephone Number : 352-744-7002
Fax Number : 352-735-3233
Provider Business Practice Location Address
First Line : 17560 US HIGHWAY 441
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-6711
Country : US
Telephone Number : 352-744-7002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2020
Last Update Date : 03/11/2026

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