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NPI Code Detail

MEDICARE: DR. DAMIAN F LUE O.D.

MEDICARE: DR. DAMIAN F LUE 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
1152W00000XOptometristOPC003021FL

General Provider Information

NPI Number : 1942394093
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAMIAN F LUE O.D.
Provider Business Mailing Address
First Line : 13365 SW 100TH TER
Second Line :
City : MIAMI
State : FL
Zip : 33186-2866
Country : US
Telephone Number : 305-558-4326
Fax Number :
Provider Business Practice Location Address
First Line : 5851 NW 177TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33015-5127
Country : US
Telephone Number : 305-558-4326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 07/08/2007

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