Provider Demographics
NPI:1336263243
Name:CIMBLER, ELIAS (LDO)
Entity Type:Individual
Prefix:MR
First Name:ELIAS
Middle Name:
Last Name:CIMBLER
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 PINE TREE DR
Mailing Address - Street 2:1503
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3628
Mailing Address - Country:US
Mailing Address - Phone:305-531-2832
Mailing Address - Fax:
Practice Address - Street 1:959 WEST AVE
Practice Address - Street 2:6
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-5201
Practice Address - Country:US
Practice Address - Phone:305-673-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO 5282156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician