Provider Demographics
NPI:1235270380
Name:VARUGHESE, SIBY (OD)
Entity Type:Individual
Prefix:DR
First Name:SIBY
Middle Name:
Last Name:VARUGHESE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16458 SW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4464
Mailing Address - Country:US
Mailing Address - Phone:954-263-6002
Mailing Address - Fax:954-458-2278
Practice Address - Street 1:16458 SW 22ND ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4464
Practice Address - Country:US
Practice Address - Phone:954-263-6002
Practice Address - Fax:954-458-2278
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3655152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist