Provider Demographics
NPI:1881048247
Name:LOH OPHTHALMOLOGY ASSOCIATES
Entity type:Organization
Organization Name:LOH OPHTHALMOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-440-7600
Mailing Address - Street 1:6705 S RED RD
Mailing Address - Street 2:SUITE 514
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3622
Mailing Address - Country:US
Mailing Address - Phone:305-602-3040
Mailing Address - Fax:305-602-3010
Practice Address - Street 1:6705 S RED RD
Practice Address - Street 2:SUITE 514
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3622
Practice Address - Country:US
Practice Address - Phone:305-602-3040
Practice Address - Fax:305-602-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110442207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty