Provider Demographics
NPI:1023109774
Name:ABUGAZALEH, ANA (LDO)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:ABUGAZALEH
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:
Other - Last Name:DETORO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LDO
Mailing Address - Street 1:7824 NW 200TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6636
Mailing Address - Country:US
Mailing Address - Phone:305-829-2928
Mailing Address - Fax:
Practice Address - Street 1:3200 S UNIVERSITY DR
Practice Address - Street 2:NSU THE EYE INSTITUTE SANFORD ZIFF 2ND FLOOR
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-4213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2523156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician