# JUAN A MENJIVAR OD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265665079
- **Authorized official:** DR. JUAN A MENJIVAR O.D. (PRESIDENT)
- **Authorized official phone:** (281) 630-6052

## Contact information

- **Practice address:** 180 S KNOWLES AVE, WINTER PARK, FL 32789-7009
- **Practice address phone:** (407) 629-2020
- **Mailing address:** 1414 SE 8TH ST, OCALA, FL 34471-4057
- **Mailing address phone:** (281) 630-6052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC4351 | FL | Yes |

## Other

- **Enumeration date:** 08/26/2009
- **Last updated:** 02/06/2013