Provider Demographics
NPI:1720210487
Name:BARAJAS, NORMA (OD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:
Last Name:BARAJAS
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 1:16428 RUBY LK
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3177
Mailing Address - Country:US
Mailing Address - Phone:954-384-2576
Mailing Address - Fax:954-384-2576
Practice Address - Street 1:8300 PARK BLVD
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-3832
Practice Address - Country:US
Practice Address - Phone:305-269-8620
Practice Address - Fax:305-267-7840
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3757152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist