Provider Demographics
NPI:1629166285
Name:YABLON, JEFF
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:YABLON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5884
Mailing Address - Country:US
Mailing Address - Phone:954-792-9111
Mailing Address - Fax:561-367-1209
Practice Address - Street 1:1375 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-5884
Practice Address - Country:US
Practice Address - Phone:954-792-9111
Practice Address - Fax:561-367-1209
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO794156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician