Provider Demographics
NPI:1619753605
Name:VOLOS, HEIDI (OD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:VOLOS
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 1:3200 SW 60TH CT STE 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4069
Mailing Address - Country:US
Mailing Address - Phone:305-662-8390
Mailing Address - Fax:305-661-7862
Practice Address - Street 1:3200 SW 60TH CT STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4069
Practice Address - Country:US
Practice Address - Phone:305-662-8390
Practice Address - Fax:305-661-7862
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2772152W00000X, 152WP0200X
FLOPC6493152WP0200X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics