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Organization
ISABEL M CARVAJAL OD PA
Active
Organization
ISABEL M CARVAJAL OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISABEL M CARVAJAL OD (PRESIDENT OPTOMETRIST)
(954) 873-4130
Entity
Organization
Contact information
Practice address
11605 PINES BLVD, PEMBROKE PINES, FL 33026-4109
(954) 438-2428
(954) 438-2450
Mailing address
5140 STAGECOACH DR, COCONUT CREEK, FL 33073-2242
(954) 438-2428
(954) 438-2429
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58551
DAVIS VISION
FL
01
—
FL4213
EYEMED
FL
05
—
PENDING
—
FL
Enumeration date
07/02/2009
Last updated
08/05/2010
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