Provider Demographics
NPI:1972633584
Name:POTASH, DAVID T (OD PA)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:POTASH
Suffix:
Gender:M
Credentials:OD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19013 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2819
Mailing Address - Country:US
Mailing Address - Phone:305-935-5250
Mailing Address - Fax:305-935-5250
Practice Address - Street 1:19013 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2819
Practice Address - Country:US
Practice Address - Phone:305-935-5250
Practice Address - Fax:305-935-5250
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3158152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist