Individual
DR. BENJAMIN THAYIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
20354 NW 2ND AVE, MIAMI GARDENS, FL 33169-2503
(305) 652-5277
Mailing address
1600 SW 78TH AVE, APT 422, PLANTATION, FL 33324-3392
(954) 600-5975
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4836
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC4836
FL
152WL0500X
Low Vision Rehabilitation Optometrist
OPC4836
FL
152WP0200X
Pediatric Optometrist
OPC4836
FL
152WS0006X
Sports Vision Optometrist
OPC4836
FL
152WV0400X
Vision Therapy Optometrist
OPC4836
FL
152WX0102X
Occupational Vision Optometrist
OPC4836
FL
Other
Enumeration date
04/30/2013
Last updated
08/27/2020
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