Provider Demographics
NPI:1710362942
Name:MUJEEB, SYED ATEF (OD)
Entity Type:Individual
Prefix:DR
First Name:SYED ATEF
Middle Name:
Last Name:MUJEEB
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16795 NW 23RD ST
Mailing Address - Street 2:APT 01-103
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1739
Mailing Address - Country:US
Mailing Address - Phone:407-952-4962
Mailing Address - Fax:
Practice Address - Street 1:8590 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2336
Practice Address - Country:US
Practice Address - Phone:305-223-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5114152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist