Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | OPC4133 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC4133 | FL |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | OPC4133 | FL |
N | 152WP0200X | Pediatric Optomitrist | OPC4133 | FL |
N | 152WS0006X | Sports Vision | OPC4133 | FL |
N | 152WV0400X | Optomitrist - Vision Therapist | OPC4133 | FL |
N | 152WX0102X | Occupational Vision | OPC4133 | FL |
NPI | 1194736405 |
---|---|
Provider Name | Dr. Heidi Guirguis |
First Address | Davie, FL 33324-5514 |
Second Address | Miami, FL 33122-1266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OPC4133 | OPTOMETRIC LICENSE (01) | FL |