Provider Demographics
NPI:1568081875
Name:ADRIAZOLA EYE GROUP
Entity Type:Organization
Organization Name:ADRIAZOLA EYE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED PERSON
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADRIAZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-467-4087
Mailing Address - Street 1:9733 SW 157TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6138
Mailing Address - Country:US
Mailing Address - Phone:305-467-4087
Mailing Address - Fax:
Practice Address - Street 1:5786 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5034
Practice Address - Country:US
Practice Address - Phone:305-262-7273
Practice Address - Fax:305-262-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty