Provider Demographics
NPI:1851708317
Name:DADA, DAVID (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DADA
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 1:2300 E SEMORAN BLVD UNIT G
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5809
Mailing Address - Country:US
Mailing Address - Phone:407-893-2733
Mailing Address - Fax:407-893-2732
Practice Address - Street 1:2300 E SEMORAN BLVD UNIT G
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5809
Practice Address - Country:US
Practice Address - Phone:407-893-2733
Practice Address - Fax:407-893-2732
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty