Provider Demographics
NPI:1659446268
Name:JOBSON, ANASTASIA CAMILLE (O D)
Entity Type:Individual
Prefix:DR
First Name:ANASTASIA
Middle Name:CAMILLE
Last Name:JOBSON
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 NE 185TH ST
Mailing Address - Street 2:#1601
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2938
Mailing Address - Country:US
Mailing Address - Phone:305-935-5067
Mailing Address - Fax:954-733-2879
Practice Address - Street 1:3001 N. STATE ROAD #7
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313
Practice Address - Country:US
Practice Address - Phone:954-497-0846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3904152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist