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NPI Code Detail

MEDICARE: DR. JENNIFER BAUZA O.D.

MEDICARE:  DR. JENNIFER  BAUZA  O.D.
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
1152W00000XOptometristOPC4423FL

General Provider Information

NPI Number : 1710211412
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER BAUZA O.D.
Provider Business Mailing Address
First Line : 5231 W 25TH CT
Second Line :
City : HIALEAH
State : FL
Zip : 33016-4072
Country : US
Telephone Number : 786-333-3338
Fax Number :
Provider Business Practice Location Address
First Line : 12055 PINES BLVD
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33026-4112
Country : US
Telephone Number : 754-400-2015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2009
Last Update Date : 01/19/2012

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Directions to “ DR. JENNIFER BAUZA O.D.” Practice Location

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