Provider Demographics
NPI:1417708462
Name:OPTOMETRY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:OPTOMETRY ASSOCIATES, LLC
Other - Org Name:OPTOMETRY ASSOCIATES, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:786-835-0428
Mailing Address - Street 1:8600 NW 41ST ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6202
Mailing Address - Country:US
Mailing Address - Phone:786-835-0428
Mailing Address - Fax:
Practice Address - Street 1:8600 NW 41ST ST STE 101
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6202
Practice Address - Country:US
Practice Address - Phone:786-835-0428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty