Individual
DR. MARYAM REZVANIABKENAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-4235
Mailing address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4237
FL
Other
Enumeration date
09/17/2007
Last updated
09/17/2007
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