Provider Demographics
NPI:1346518875
Name:LUCY BENARD OD PA
Entity Type:Organization
Organization Name:LUCY BENARD OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:BENARD-ZELEDON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:786-999-4205
Mailing Address - Street 1:14974 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2505
Mailing Address - Country:US
Mailing Address - Phone:786-999-4205
Mailing Address - Fax:
Practice Address - Street 1:13600 SW 288TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1905
Practice Address - Country:US
Practice Address - Phone:305-248-8883
Practice Address - Fax:844-814-2970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3685152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty