Provider Demographics
NPI:1780337030
Name:REYHANOGLU, ESRA (OD)
Entity type:Individual
Prefix:DR
First Name:ESRA
Middle Name:
Last Name:REYHANOGLU
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 1:3 CURVED CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-1805
Mailing Address - Country:US
Mailing Address - Phone:386-882-8682
Mailing Address - Fax:
Practice Address - Street 1:702 S DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2519
Practice Address - Country:US
Practice Address - Phone:813-951-2354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6037152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist