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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

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Optician, Dispensing · PEMBROKE PARK, FL

Registration Details

NPI Number
1871009720
Provider Type
Individual
Gender
Male
NPI Issued
Dec 14, 2017 (8.3507697942431 yrs)
Last Updated
Dec 14, 2017
License
5161 (FL)

Practice Information

Address
4520 W HALLANDALE BEACH BLVD STE 8
PEMBROKE PARK, FL, 330234344
Browse FL providers · Browse ZIP 33023
Phone
3054694596
Primary Specialty
Optician, Dispensing
156FX1800X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.