Provider Demographics
NPI:1568934438
Name:ROZADA, LAURA (OD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:ROZADA
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 1:153 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4847
Mailing Address - Country:US
Mailing Address - Phone:786-399-9614
Mailing Address - Fax:
Practice Address - Street 1:8060 NW 155TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5883
Practice Address - Country:US
Practice Address - Phone:305-364-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5613152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist