Provider Demographics
NPI:1700989845
Name:LUZON, ELON PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:ELON
Middle Name:PAUL
Last Name:LUZON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PALM BEACH LAKES BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6503
Mailing Address - Country:US
Mailing Address - Phone:561-478-2015
Mailing Address - Fax:561-478-1300
Practice Address - Street 1:2000 PALM BEACH LAKES BLVD
Practice Address - Street 2:STE 400
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6503
Practice Address - Country:US
Practice Address - Phone:561-478-2015
Practice Address - Fax:561-478-1300
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007071-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC501G1Medicare PIN