| Dr Khai Gia Phan, OD | |
|
19501 Nw 27th Ave, Miami Gardens, FL 33056-2521 | |
| (305) 974-2588 | |
| Not Available |
| Full Name | Dr Khai Gia Phan |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 19501 Nw 27th Ave, Miami Gardens, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417077710 | NPI | - | NPPES |
| 014191100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OPC3501 (Florida) | Primary |
| Provider Name | Myeyedr Optometry Of Florida, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073907028 PECOS PAC ID: 0143541037 Enrollment ID: O20150603002802 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Khai Gia Phan, OD 19501 Nw 27th Ave, Miami Gardens, FL 33056-2521 Ph: (305) 974-2588 | Dr Khai Gia Phan, OD 19501 Nw 27th Ave, Miami Gardens, FL 33056-2521 Ph: (305) 974-2588 |
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