Provider Demographics
NPI:1780245431
Name:HAZIEN, MONICA LAUREN (OD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LAUREN
Last Name:HAZIEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LAUREN
Other - Last Name:HAZIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8000 NW 70TH AVE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3966
Mailing Address - Country:US
Mailing Address - Phone:561-609-7030
Mailing Address - Fax:
Practice Address - Street 1:7045 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2205
Practice Address - Country:US
Practice Address - Phone:954-625-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5706152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist