# JOSEALIX DAVERMAN OD PA

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

## Provider details

- **NPI number:** 1649576059
- **Authorized official:** DR. JOSEALIX DAVERMAN O.D. (PRESIDENT)
- **Authorized official phone:** (954) 249-7548

## Contact information

- **Practice address:** 5920 W SAMPLE RD \# 105-7, CORAL SPRINGS, FL 33067-3251
- **Practice address phone:** (954) 249-7548
- **Mailing address:** 6841 MIRAMAR PKWY, MIRAMAR, FL 33023-6023
- **Mailing address phone:** (954) 967-9017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC3885 | NULL | Yes |
| 152W00000X | Optometrist | OPC3885 | — | Yes |

## Other

- **Enumeration date:** 02/02/2011
- **Last updated:** 02/02/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2775155 | UNITED HEALTH CARE | FL |
| 01 | — | 36141 | BLUECROSS BLUESHIELDS | — |
| 01 | — | 9195136 | AETNA | — |
| 01 | — | FL3885 | EYEMED | — |