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NPI Code Detail

MEDICARE: JOSEFINA OPTICAL CENTER INC

MEDICARE: JOSEFINA OPTICAL CENTER INC
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
1152W00000XOptometrist0P1330FL

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 : 1831496462
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEFINA OPTICAL CENTER INC
Provider Business Mailing Address
First Line : 5372 W 16TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-2165
Country : US
Telephone Number : 786-478-3554
Fax Number :
Provider Business Practice Location Address
First Line : 5372 W 16TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-2165
Country : US
Telephone Number : 786-478-3554
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JUANA JOSEFINA MUNIZ
Credential : O.D.
Telephone Number : 305-884-3346
Provider Enumeration Date : 02/17/2011
Last Update Date : 10/08/2013

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Directions to “JOSEFINA OPTICAL CENTER INC ” Practice Location

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