Provider Demographics
NPI:1891746392
Name:DUFEK, MICHAEL (OPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DUFEK
Suffix:
Gender:M
Credentials:OPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10860 SW 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2680
Mailing Address - Country:US
Mailing Address - Phone:305-595-1300
Mailing Address - Fax:305-275-8988
Practice Address - Street 1:10860 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2680
Practice Address - Country:US
Practice Address - Phone:305-595-1300
Practice Address - Fax:305-275-8988
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2809152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOPC2809OtherOPTOMETRIST LICENSE