Provider Demographics
NPI:1053488601
Name:WORSLEY, NATALIYA (OPTOMETRIST)
Entity Type:Individual
Prefix:DR
First Name:NATALIYA
Middle Name:
Last Name:WORSLEY
Suffix:
Gender:F
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 NW 6TH CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6156
Mailing Address - Country:US
Mailing Address - Phone:954-443-3335
Mailing Address - Fax:
Practice Address - Street 1:9930 NW 6TH CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6156
Practice Address - Country:US
Practice Address - Phone:954-443-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3752152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6211133000Medicaid
FL6211133000Medicaid