# MIRIAM MENDIVIL OD, PA

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

## Provider details

- **NPI number:** 1457641227
- **Authorized official:** DR. MIRIAM MENDIVIL OD (PRESIDENT)
- **Authorized official phone:** (305) 905-9184

## Contact information

- **Practice address:** 5434 SW 8TH ST, CORAL GABLES, FL 33134-2267
- **Practice address phone:** (305) 444-8676
- **Mailing address:** 3180 SW 129TH AVE, MIAMI, FL 33175-2508
- **Mailing address phone:** (305) 905-9184
- **Mailing address fax:** (305) 225-3986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC4038 | FL | Yes |

## Other

- **Enumeration date:** 04/14/2011
- **Last updated:** 12/21/2023