Provider Demographics
NPI:1265748313
Name:ALCINOR, MARLYNE (OD)
Entity type:Individual
Prefix:
First Name:MARLYNE
Middle Name:
Last Name:ALCINOR
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 1:660 NE 83RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-4118
Mailing Address - Country:US
Mailing Address - Phone:786-543-2713
Mailing Address - Fax:
Practice Address - Street 1:660 NE 83RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-4118
Practice Address - Country:US
Practice Address - Phone:786-543-2713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4508152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist