| Nova Southeastern University, Inc | |
|
650 North Andrews Avenue, Ft. Lauderdale, FL 33311-7436 | |
| (954) 262-4100 | |
| (954) 262-6888 |
| Full Name | Nova Southeastern University, Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 650 North Andrews Avenue, Ft. Lauderdale, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700924511 | NPI | - | NPPES |
| 078488503 | Medicaid | FL | |
| 98673 | Other | FL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 156FX1800X | Technician/technologist - Optician | (* (Not Available)) | Secondary |
| Provider Name | Eulogio Besada |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538234711 PECOS PAC ID: 6901705938 Enrollment ID: I20040108000098 |
| Provider Name | Susan Ledbetter |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1780620476 PECOS PAC ID: 3678466943 Enrollment ID: I20040203000110 |
| Provider Name | Hamid R Feiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427032226 PECOS PAC ID: 5991794844 Enrollment ID: I20040507000199 |
| Provider Name | Judith P Schaffer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1427146166 PECOS PAC ID: 9032109863 Enrollment ID: I20040514000122 |
| Provider Name | Diane Stern |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1902913601 PECOS PAC ID: 1658354030 Enrollment ID: I20040608000545 |
| Provider Name | Amandip Sappal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457467532 PECOS PAC ID: 8820069834 Enrollment ID: I20040804000243 |
| Provider Name | Rogerio Faillace |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902977663 PECOS PAC ID: 7911966932 Enrollment ID: I20041006000401 |
| Provider Name | Rachel A Coulter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760556609 PECOS PAC ID: 2062472202 Enrollment ID: I20041013000245 |
| Provider Name | Zoeanne Schinas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376618686 PECOS PAC ID: 5496716771 Enrollment ID: I20041020000655 |
| Provider Name | Jacqueline Rodena |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336214691 PECOS PAC ID: 3779544994 Enrollment ID: I20041021000360 |
| Provider Name | Andrea M Janoff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922172766 PECOS PAC ID: 5496716649 Enrollment ID: I20041021000653 |
| Provider Name | Hadley N Saitowitz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912088105 PECOS PAC ID: 0244293751 Enrollment ID: I20041105000614 |
| Provider Name | Samuel Snyder |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1093749111 PECOS PAC ID: 3476517053 Enrollment ID: I20041113000180 |
| Provider Name | Carlos H Nousari |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1477538940 PECOS PAC ID: 3173589280 Enrollment ID: I20041209000360 |
| Provider Name | Annette Bade |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891871331 PECOS PAC ID: 2961454822 Enrollment ID: I20050218000526 |
| Provider Name | Yin Tea |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982779294 PECOS PAC ID: 6406809599 Enrollment ID: I20050301000601 |
| Provider Name | Brian S Russ |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417056821 PECOS PAC ID: 2466407028 Enrollment ID: I20050316000545 |
| Provider Name | Winston Alexis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235134917 PECOS PAC ID: 0749218857 Enrollment ID: I20050730000034 |
| Provider Name | Thuy Lan D Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992805261 PECOS PAC ID: 0446280119 Enrollment ID: I20050813000011 |
| Provider Name | Nicole Patterson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942375712 PECOS PAC ID: 8527086289 Enrollment ID: I20051110000794 |
| Provider Name | Beata I Lewandowska |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104817337 PECOS PAC ID: 6406862945 Enrollment ID: I20060221000817 |
| Provider Name | Shahnaz Fatteh |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1588632533 PECOS PAC ID: 3274545587 Enrollment ID: I20060630000240 |
| Provider Name | Ingrid D Carter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114981883 PECOS PAC ID: 2062425812 Enrollment ID: I20060720000124 |
| Provider Name | Rebecca M Cherner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396784237 PECOS PAC ID: 5799881348 Enrollment ID: I20070428000089 |
| Provider Name | Natasha Bray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285840660 PECOS PAC ID: 2163516881 Enrollment ID: I20070925000532 |
| Provider Name | Shawn A Mcclure |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1649313925 PECOS PAC ID: 8921194333 Enrollment ID: I20071017000276 |
| Provider Name | Eustorgio A Lopez |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1730145061 PECOS PAC ID: 9830286228 Enrollment ID: I20071101000270 |
| Provider Name | Ovidio Olivencia |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922181700 PECOS PAC ID: 5395833974 Enrollment ID: I20071115000156 |
| Provider Name | Nhu T Beteta |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740475870 PECOS PAC ID: 1052401668 Enrollment ID: I20071219000858 |
| Provider Name | Jamie L. Althoff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972703148 PECOS PAC ID: 8921198458 Enrollment ID: I20071220000157 |
| Provider Name | Marlon J Monelyon-demeritt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588875157 PECOS PAC ID: 2860576469 Enrollment ID: I20080220000647 |
| Provider Name | Eduardo R Locatelli |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1982667994 PECOS PAC ID: 8729162771 Enrollment ID: I20080228000578 |
| Provider Name | Nadine Girgis-hanna |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003004870 PECOS PAC ID: 1557265659 Enrollment ID: I20080522000447 |
| Provider Name | David R Boesler |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1740272400 PECOS PAC ID: 0244242741 Enrollment ID: I20080523000448 |
| Provider Name | Anjali Bhasin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104895887 PECOS PAC ID: 7810921368 Enrollment ID: I20080717000303 |
| Provider Name | Darren J Cohen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285715649 PECOS PAC ID: 5294832036 Enrollment ID: I20080825000614 |
| Provider Name | Miriam H Farag |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801984059 PECOS PAC ID: 1557382587 Enrollment ID: I20080903000459 |
| Provider Name | Peter A. Sprague |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497957633 PECOS PAC ID: 8527134733 Enrollment ID: I20080911000219 |
| Provider Name | Allan W Bloom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780698902 PECOS PAC ID: 7517035082 Enrollment ID: I20081010000281 |
| Provider Name | Kenya M Rivas Velasquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134395288 PECOS PAC ID: 7517025786 Enrollment ID: I20081017000205 |
| Provider Name | Vincent F Guida |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407870181 PECOS PAC ID: 6507924529 Enrollment ID: I20081021000173 |
| Provider Name | Annette Fornos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922217116 PECOS PAC ID: 6103984133 Enrollment ID: I20081021000229 |
| Provider Name | John H Shook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497769517 PECOS PAC ID: 3375602311 Enrollment ID: I20081106000192 |
| Provider Name | Marilyn S Gordon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679751556 PECOS PAC ID: 1355412610 Enrollment ID: I20090123000585 |
| Provider Name | Patricia Ann Gaffney |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1407896491 PECOS PAC ID: 3476601550 Enrollment ID: I20090429000253 |
| Provider Name | Gregory M Fecho |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114091956 PECOS PAC ID: 4385793603 Enrollment ID: I20090515000460 |
| Provider Name | Sherrol Reynolds |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639244437 PECOS PAC ID: 7810046034 Enrollment ID: I20090519000241 |
| Provider Name | Kenneth Seger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487729794 PECOS PAC ID: 5193874766 Enrollment ID: I20090601000548 |
| Provider Name | Barry Frauens |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750455598 PECOS PAC ID: 1254481716 Enrollment ID: I20090604000410 |
| Provider Name | Deborah M Amster |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770658940 PECOS PAC ID: 0244380624 Enrollment ID: I20090604000632 |
| Provider Name | Perla G Najman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194899930 PECOS PAC ID: 1850441692 Enrollment ID: I20090616000738 |
| Provider Name | Julie Rodman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679673313 PECOS PAC ID: 6709936487 Enrollment ID: I20090618000565 |
| Provider Name | Bruce B Peters |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538108758 PECOS PAC ID: 5294815296 Enrollment ID: I20090716000527 |
| Provider Name | Farzanna S Haffizulla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275605321 PECOS PAC ID: 7113073370 Enrollment ID: I20090914000480 |
| Provider Name | Renee Alexis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780775726 PECOS PAC ID: 7012063217 Enrollment ID: I20090915000254 |
| Provider Name | Melanie Crandall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578637419 PECOS PAC ID: 0446306880 Enrollment ID: I20090925000443 |
| Provider Name | Tye Barber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275795486 PECOS PAC ID: 3577609536 Enrollment ID: I20091005000400 |
| Provider Name | Jackie Davie |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1932342953 PECOS PAC ID: 8921144718 Enrollment ID: I20091008000224 |
| Provider Name | Nicole Andriesse |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1780811851 PECOS PAC ID: 9830238211 Enrollment ID: I20091124000294 |
| Provider Name | Irma Rey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720046238 PECOS PAC ID: 7911047154 Enrollment ID: I20091218000107 |
| Provider Name | Hady Masri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720215122 PECOS PAC ID: 8022158112 Enrollment ID: I20091222000110 |
| Provider Name | Melissa Tabor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144471152 PECOS PAC ID: 9931241528 Enrollment ID: I20100120000389 |
| Provider Name | Hua Bi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447328265 PECOS PAC ID: 4486759586 Enrollment ID: I20100212000433 |
| Provider Name | Erin C Jenewein |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154654754 PECOS PAC ID: 1355485178 Enrollment ID: I20100217000659 |
| Provider Name | Steven Kaltman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1790870046 PECOS PAC ID: 8820125255 Enrollment ID: I20100416000206 |
| Provider Name | Doris Newman |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1740265529 PECOS PAC ID: 5890738017 Enrollment ID: I20100520001006 |
| Provider Name | Mark Gabay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659543379 PECOS PAC ID: 0143350041 Enrollment ID: I20100618000386 |
| Provider Name | Marie Florent-carre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750612529 PECOS PAC ID: 3274663141 Enrollment ID: I20100621000175 |
| Provider Name | Jill A Wallace-ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770722043 PECOS PAC ID: 9830222801 Enrollment ID: I20100728000956 |
| Provider Name | Barbara Arcos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629153010 PECOS PAC ID: 1254464712 Enrollment ID: I20100804000394 |
| Provider Name | Peter Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407934110 PECOS PAC ID: 2062546609 Enrollment ID: I20100817001614 |
| Provider Name | Cheryl Atherley-todd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609994417 PECOS PAC ID: 2365576659 Enrollment ID: I20100823000925 |
| Provider Name | Sandi Scott-holman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437198157 PECOS PAC ID: 3971628967 Enrollment ID: I20100914001102 |
| Provider Name | Dennis Penzell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043243132 PECOS PAC ID: 9234048901 Enrollment ID: I20100928000143 |
| Provider Name | Janet L Leasher |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982734166 PECOS PAC ID: 0749212090 Enrollment ID: I20101025001344 |
| Provider Name | Nancy Klimas |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1972532265 PECOS PAC ID: 2961698386 Enrollment ID: I20101124000988 |
| Provider Name | Lisa K Lashley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336448760 PECOS PAC ID: 0143406975 Enrollment ID: I20110512000393 |
| Provider Name | Cristina E Savu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437448867 PECOS PAC ID: 8426227133 Enrollment ID: I20110815000804 |
| Provider Name | Sarah Wakefield |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1639314487 PECOS PAC ID: 2860662798 Enrollment ID: I20110831000534 |
| Provider Name | Mark Sandhouse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780640862 PECOS PAC ID: 4284807728 Enrollment ID: I20111028000639 |
| Provider Name | Joseph Degaetano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548226657 PECOS PAC ID: 6800069238 Enrollment ID: I20111101000248 |
| Provider Name | Naushira Pandya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275692584 PECOS PAC ID: 0345413613 Enrollment ID: I20111101000751 |
| Provider Name | Kenneth Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760597009 PECOS PAC ID: 3577739077 Enrollment ID: I20120105000121 |
| Provider Name | Michelle L Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306944129 PECOS PAC ID: 0345417689 Enrollment ID: I20120127000039 |
| Provider Name | Robert Emmett Rego |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851675524 PECOS PAC ID: 4981861127 Enrollment ID: I20120131000518 |
| Provider Name | Rim Makhlouf |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114202165 PECOS PAC ID: 2264699776 Enrollment ID: I20120209000796 |
| Provider Name | Julie Tyler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396821955 PECOS PAC ID: 8921265356 Enrollment ID: I20120213000515 |
| Provider Name | Paula L Anderson-worts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205886231 PECOS PAC ID: 3375701501 Enrollment ID: I20120220000808 |
| Provider Name | Gregory Scott Black |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144306796 PECOS PAC ID: 7517126899 Enrollment ID: I20120306000300 |
| Provider Name | Laura A Falco |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396819132 PECOS PAC ID: 0648432708 Enrollment ID: I20120507000498 |
| Provider Name | Barbara Ann Wells |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1386875573 PECOS PAC ID: 6406018480 Enrollment ID: I20120509000232 |
| Provider Name | Linda Rouse |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114003902 PECOS PAC ID: 7517120678 Enrollment ID: I20120530000155 |
| Provider Name | Bradley Ingrao |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1932338985 PECOS PAC ID: 0941464234 Enrollment ID: I20120618000559 |
| Provider Name | Michelle C Duhaney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871816835 PECOS PAC ID: 5496911521 Enrollment ID: I20120718000253 |
| Provider Name | Paula Dilanchian |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1477708576 PECOS PAC ID: 5698931624 Enrollment ID: I20120719000382 |
| Provider Name | Pamela Moran-walcutt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982832283 PECOS PAC ID: 1658537253 Enrollment ID: I20120726000272 |
| Provider Name | Erica Friedland |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1356425094 PECOS PAC ID: 6406003755 Enrollment ID: I20120822000129 |
| Provider Name | Katina Y Brown-burgess |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356438675 PECOS PAC ID: 6305844044 Enrollment ID: I20120827000430 |
| Provider Name | Alexandra Espejo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457425381 PECOS PAC ID: 2062660335 Enrollment ID: I20120911000259 |
| Provider Name | Michael Au |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629327002 PECOS PAC ID: 2567611486 Enrollment ID: I20121011000077 |
| Provider Name | Kayla Ann Chomko |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235401290 PECOS PAC ID: 0547410623 Enrollment ID: I20121025000757 |
| Provider Name | Lauren C Gray |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1235483124 PECOS PAC ID: 4981856523 Enrollment ID: I20121206000377 |
| Provider Name | Adriana R Carcamo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922381409 PECOS PAC ID: 9830343151 Enrollment ID: I20130213000445 |
| Provider Name | Violetta E Renesca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457696387 PECOS PAC ID: 2365697240 Enrollment ID: I20130226000146 |
| Provider Name | Roody Joseph |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831439884 PECOS PAC ID: 2567608896 Enrollment ID: I20130411000279 |
| Provider Name | Lynn W Solomon |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1619056280 PECOS PAC ID: 5496859910 Enrollment ID: I20130626000569 |
| Provider Name | Kristi W Ricks |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922358001 PECOS PAC ID: 8527208503 Enrollment ID: I20130716000491 |
| Provider Name | Elizabeth Muller Hames |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578791448 PECOS PAC ID: 9133360563 Enrollment ID: I20130729000337 |
| Provider Name | April M Thomson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336481522 PECOS PAC ID: 4385886688 Enrollment ID: I20130816000180 |
| Provider Name | Leon Nehmad |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033294111 PECOS PAC ID: 5991979833 Enrollment ID: I20130828000533 |
| Provider Name | Luzan Phillpotts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679868806 PECOS PAC ID: 6608010202 Enrollment ID: I20130923000191 |
| Provider Name | Anna Kauderman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851726384 PECOS PAC ID: 3274769492 Enrollment ID: I20131118001655 |
| Provider Name | Christian Hernandez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659705465 PECOS PAC ID: 0749416832 Enrollment ID: I20131119002014 |
| Provider Name | Kellie Bassion |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861826679 PECOS PAC ID: 4587890843 Enrollment ID: I20131218001497 |
| Provider Name | Alyssa R Needleman |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1184896136 PECOS PAC ID: 3971728841 Enrollment ID: I20140709000814 |
| Provider Name | Sonia Daryanani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366852931 PECOS PAC ID: 4688890924 Enrollment ID: I20140723001185 |
| Provider Name | Traci-lyn Eisenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053607630 PECOS PAC ID: 6608095609 Enrollment ID: I20140923001768 |
| Provider Name | Ava K Bittner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457308793 PECOS PAC ID: 2668406984 Enrollment ID: I20140924001301 |
| Provider Name | Steven Ellen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1417087099 PECOS PAC ID: 2567357031 Enrollment ID: I20141002001455 |
| Provider Name | Sara Lesley Berke |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265846240 PECOS PAC ID: 2264653096 Enrollment ID: I20141021000982 |
| Provider Name | Kara Allison Collier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295143477 PECOS PAC ID: 4082835731 Enrollment ID: I20141021001879 |
| Provider Name | Jessica Arielle Steen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649688847 PECOS PAC ID: 6709007396 Enrollment ID: I20141023002347 |
| Provider Name | Cory Matthew Collier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972911147 PECOS PAC ID: 7315168689 Enrollment ID: I20141030000631 |
| Provider Name | Mariem Abdou |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366882458 PECOS PAC ID: 9032351671 Enrollment ID: I20141030001361 |
| Provider Name | Diane E Ede Nichols |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225145683 PECOS PAC ID: 3072734235 Enrollment ID: I20141031002181 |
| Provider Name | Kira Fenton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740579945 PECOS PAC ID: 7113249640 Enrollment ID: I20141211000698 |
| Provider Name | Robert E Block |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1245362516 PECOS PAC ID: 1052633500 Enrollment ID: I20141211001308 |
| Provider Name | Alessandra Posey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225370257 PECOS PAC ID: 1456674951 Enrollment ID: I20150107002002 |
| Provider Name | So Yeon Lee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518093160 PECOS PAC ID: 8022107572 Enrollment ID: I20150129001510 |
| Provider Name | Stella Elberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437562048 PECOS PAC ID: 9537486501 Enrollment ID: I20150401000491 |
| Provider Name | Thomas P Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346383924 PECOS PAC ID: 6901034081 Enrollment ID: I20150402001783 |
| Provider Name | Oneka Marriott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629325709 PECOS PAC ID: 1951629690 Enrollment ID: I20150409001356 |
| Provider Name | Cyril Blavo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285742569 PECOS PAC ID: 9436477189 Enrollment ID: I20150409002076 |
| Provider Name | Patrick E Barry |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1194060756 PECOS PAC ID: 9739408998 Enrollment ID: I20150511000402 |
| Provider Name | Michael J Defranco |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316060148 PECOS PAC ID: 2365543857 Enrollment ID: I20150720000778 |
| Provider Name | Miriam Anglo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144602160 PECOS PAC ID: 0840506838 Enrollment ID: I20150908000531 |
| Provider Name | Jasleen Jhajj |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285043943 PECOS PAC ID: 7214155332 Enrollment ID: I20151012000537 |
| Provider Name | Leticia Alexandra Rousso |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083099725 PECOS PAC ID: 5193034015 Enrollment ID: I20151015001916 |
| Provider Name | Stacy Rochelle Zubkousky |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609251354 PECOS PAC ID: 7911216734 Enrollment ID: I20151019001110 |
| Provider Name | Sahar S Amini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538547096 PECOS PAC ID: 7517276355 Enrollment ID: I20151019001617 |
| Provider Name | Almas Khan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093190738 PECOS PAC ID: 7012226475 Enrollment ID: I20151026001320 |
| Provider Name | Casey M Peterson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033585161 PECOS PAC ID: 3870802242 Enrollment ID: I20151026002018 |
| Provider Name | Pinar Haytac |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073989091 PECOS PAC ID: 4981913365 Enrollment ID: I20151026002456 |
| Provider Name | Katherine Elizabeth Green |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538541073 PECOS PAC ID: 4981905833 Enrollment ID: I20151217001313 |
| Provider Name | Noel Alonso |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902985344 PECOS PAC ID: 0042514762 Enrollment ID: I20160201001199 |
| Provider Name | Irina Rozenfeld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417292509 PECOS PAC ID: 5597060897 Enrollment ID: I20160224002151 |
| Provider Name | Jocelyn A Cohen |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1760652937 PECOS PAC ID: 6800192063 Enrollment ID: I20160315000160 |
| Provider Name | Helene R Fisher |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1720199656 PECOS PAC ID: 8325344500 Enrollment ID: I20160315000808 |
| Provider Name | Lea Kaploun |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1508038563 PECOS PAC ID: 1052617255 Enrollment ID: I20160315001166 |
| Provider Name | Leslie J Miller |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1588767693 PECOS PAC ID: 2163728270 Enrollment ID: I20160315001778 |
| Provider Name | Tambi Braun |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1861594947 PECOS PAC ID: 1456657576 Enrollment ID: I20160315002041 |
| Provider Name | Rachel M Williams |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1053413195 PECOS PAC ID: 8123324241 Enrollment ID: I20160315002198 |
| Provider Name | Shane S Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346629037 PECOS PAC ID: 8628369865 Enrollment ID: I20160620001540 |
| Provider Name | Carlos Ladeira |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144397365 PECOS PAC ID: 9436442985 Enrollment ID: I20160721001862 |
| Provider Name | Nicole Quint |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528029824 PECOS PAC ID: 6305139767 Enrollment ID: I20160721002460 |
| Provider Name | Melissa M. Tovin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861548026 PECOS PAC ID: 2062705437 Enrollment ID: I20160721002685 |
| Provider Name | Steven J Pfister |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568533933 PECOS PAC ID: 2567755614 Enrollment ID: I20160727000226 |
| Provider Name | Nicholas D Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265986558 PECOS PAC ID: 1850688045 Enrollment ID: I20161003002320 |
| Provider Name | Man Kin Chow |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417307620 PECOS PAC ID: 4688962087 Enrollment ID: I20161018002746 |
| Provider Name | Lindsay Baker Howse |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295188845 PECOS PAC ID: 1759669062 Enrollment ID: I20161020001218 |
| Provider Name | Samantha Kimberly Mcintosh |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770936742 PECOS PAC ID: 7719265875 Enrollment ID: I20161025002581 |
| Provider Name | Denise Kruszynski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982089389 PECOS PAC ID: 9931488012 Enrollment ID: I20161112000027 |
| Provider Name | Margaret A Wilczek |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831542273 PECOS PAC ID: 5597045765 Enrollment ID: I20161205000986 |
| Provider Name | Tsung-hao Wu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023469046 PECOS PAC ID: 5890075089 Enrollment ID: I20161205001699 |
| Provider Name | Nathalie Elizabeth Findlater |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306212873 PECOS PAC ID: 1557678943 Enrollment ID: I20161219000614 |
| Provider Name | Amar Sayani |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134435514 PECOS PAC ID: 5597941690 Enrollment ID: I20170110000118 |
| Provider Name | Gina Foster-moumoutjis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730347030 PECOS PAC ID: 6103976964 Enrollment ID: I20170201002679 |
| Provider Name | Nathan Patrick Widboom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144565532 PECOS PAC ID: 6204119993 Enrollment ID: I20170202002049 |
| Provider Name | Leigh Purvis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710430673 PECOS PAC ID: 9739462821 Enrollment ID: I20170215003051 |
| Provider Name | Anthony H. Bezerra |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1972800852 PECOS PAC ID: 1850675372 Enrollment ID: I20170301001379 |
| Provider Name | Rania Margonis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992247241 PECOS PAC ID: 2668756107 Enrollment ID: I20170301002305 |
| Provider Name | Fareeda Salma Baksh-deen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215375647 PECOS PAC ID: 6204155484 Enrollment ID: I20170321002002 |
| Provider Name | Marc Monroe Kesselman |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1285685115 PECOS PAC ID: 1456305309 Enrollment ID: I20170622002941 |
| Provider Name | Carol Yu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639697451 PECOS PAC ID: 9436415585 Enrollment ID: I20171107001040 |
| Provider Name | Heather Rose Gauger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003334863 PECOS PAC ID: 2264798826 Enrollment ID: I20171114003541 |
| Provider Name | Daniela M Berrios |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1457872749 PECOS PAC ID: 3173880317 Enrollment ID: I20171127001787 |
| Provider Name | Katharine Lynn Fitzharris |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1316170137 PECOS PAC ID: 8527346980 Enrollment ID: I20171219001870 |
| Provider Name | Samantha Kayser |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730699943 PECOS PAC ID: 4385904390 Enrollment ID: I20180213002333 |
| Provider Name | Lissette Lazo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003208083 PECOS PAC ID: 6002109550 Enrollment ID: I20180214002737 |
| Provider Name | Jennifer Olivia Carr-hertel |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881127579 PECOS PAC ID: 6901167626 Enrollment ID: I20180220003131 |
| Provider Name | Rohit S Mehra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265854897 PECOS PAC ID: 3173884434 Enrollment ID: I20180228002969 |
| Provider Name | Sharla B Jefferson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1689172678 PECOS PAC ID: 2062776792 Enrollment ID: I20180504002212 |
| Provider Name | Kimberly Blaker-smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093087512 PECOS PAC ID: 0547514390 Enrollment ID: I20181113003269 |
| Provider Name | Deborah Jessurun |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780162446 PECOS PAC ID: 1456605922 Enrollment ID: I20181120000595 |
| Provider Name | Swati Kumar |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922583665 PECOS PAC ID: 1153675541 Enrollment ID: I20181121002716 |
| Provider Name | Andrea M Horbey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669825634 PECOS PAC ID: 1153675442 Enrollment ID: I20181127000799 |
| Provider Name | Lailah Issac |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1629398441 PECOS PAC ID: 1759510993 Enrollment ID: I20181218003490 |
| Provider Name | Nannette C Nicholson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1508088055 PECOS PAC ID: 4385827369 Enrollment ID: I20181231001226 |
| Provider Name | Desiree Alexis Wheeler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609351022 PECOS PAC ID: 8527304609 Enrollment ID: I20190110000841 |
| Provider Name | Sadie Vega-velasquez |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1447750260 PECOS PAC ID: 6406192038 Enrollment ID: I20190117003531 |
| Provider Name | Ryan Clyde Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073008058 PECOS PAC ID: 1557608858 Enrollment ID: I20190124001547 |
| Provider Name | Tiana Tamara Berezu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801376124 PECOS PAC ID: 3072850320 Enrollment ID: I20190124003375 |
| Provider Name | Anna Claire Jean Spradling |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154814432 PECOS PAC ID: 5092052910 Enrollment ID: I20190130000734 |
| Provider Name | Christian Corzo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831682178 PECOS PAC ID: 8325385024 Enrollment ID: I20190201001896 |
| Provider Name | Felicia J Timmermann |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265846703 PECOS PAC ID: 9436476462 Enrollment ID: I20190221000656 |
| Provider Name | Melissa Wisan Edrich |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1538271911 PECOS PAC ID: 7012257595 Enrollment ID: I20190320000177 |
| Provider Name | Gabriela Lopes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326526377 PECOS PAC ID: 1456691625 Enrollment ID: I20190326001114 |
| Provider Name | Mariana Coelho Ferraz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043872088 PECOS PAC ID: 3577890839 Enrollment ID: I20190808002424 |
| Provider Name | Esther Park |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477106102 PECOS PAC ID: 6103153242 Enrollment ID: I20190812002684 |
| Provider Name | Lauren Nicholas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790341543 PECOS PAC ID: 4284961376 Enrollment ID: I20190813000556 |
| Provider Name | Reena Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568024610 PECOS PAC ID: 3173851508 Enrollment ID: I20190823000597 |
| Provider Name | Mickinzee Diane Combs |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891349247 PECOS PAC ID: 7719215839 Enrollment ID: I20190827001558 |
| Provider Name | Elizabeth Fernandez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417497280 PECOS PAC ID: 7911330626 Enrollment ID: I20191211001975 |
| Provider Name | Marina Ishak Abdalla |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720573173 PECOS PAC ID: 8527494657 Enrollment ID: I20200207000822 |
| Provider Name | Erin Lynn Beasley |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1699935767 PECOS PAC ID: 1557797495 Enrollment ID: I20200212001403 |
| Provider Name | Nicholas John Arcos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386008829 PECOS PAC ID: 5799076600 Enrollment ID: I20200225002343 |
| Provider Name | Kevin Willeford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922413558 PECOS PAC ID: 0547506925 Enrollment ID: I20200316001280 |
| Provider Name | Anastasiya Quimby |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1750720116 PECOS PAC ID: 2264732882 Enrollment ID: I20200601000261 |
| Provider Name | Caroline Dadowski |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1841816972 PECOS PAC ID: 6204259195 Enrollment ID: I20200710001565 |
| Provider Name | Natasha Michelle Nicola M Tetlow |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437779758 PECOS PAC ID: 6709201676 Enrollment ID: I20200810001490 |
| Provider Name | Xiaojing Yu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497143358 PECOS PAC ID: 3779822069 Enrollment ID: I20200827001202 |
| Provider Name | Nicholas Green |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922532811 PECOS PAC ID: 3274807797 Enrollment ID: I20200902001692 |
| Provider Name | Dieu Thi Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720602634 PECOS PAC ID: 5395164461 Enrollment ID: I20200923002915 |
| Provider Name | Deborah Ann Mulligan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316974322 PECOS PAC ID: 1850710864 Enrollment ID: I20200924001572 |
| Provider Name | Laura Lynn Campos |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1609125590 PECOS PAC ID: 9830343995 Enrollment ID: I20201008000296 |
| Provider Name | Ryan-quang Van |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801411392 PECOS PAC ID: 9830519826 Enrollment ID: I20201013001455 |
| Provider Name | Gisselle Stephanie Calero |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619592607 PECOS PAC ID: 5496175010 Enrollment ID: I20201021001148 |
| Provider Name | Yaseen Waqar |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417568635 PECOS PAC ID: 6305266768 Enrollment ID: I20201023001249 |
| Provider Name | Gregory Hill |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003868860 PECOS PAC ID: 1759398696 Enrollment ID: I20201027001131 |
| Provider Name | Sydney S Lin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184241465 PECOS PAC ID: 0446660229 Enrollment ID: I20201105002486 |
| Provider Name | Samantha Krueger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013534528 PECOS PAC ID: 7618387341 Enrollment ID: I20201106002054 |
| Provider Name | Karah Gottschalk |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1457772253 PECOS PAC ID: 8527297431 Enrollment ID: I20201113001837 |
| Provider Name | Ariela Baran |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740805712 PECOS PAC ID: 6204247547 Enrollment ID: I20201118000482 |
| Provider Name | Brice Chen Hsu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902422793 PECOS PAC ID: 7315358819 Enrollment ID: I20201203002443 |
| Provider Name | Megan Kim |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881054427 PECOS PAC ID: 6507272218 Enrollment ID: I20210304000279 |
| Provider Name | Nadine Mikati |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295371870 PECOS PAC ID: 2365850054 Enrollment ID: I20210419000786 |
| Provider Name | Crystal Kaye Victor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124645056 PECOS PAC ID: 6103234471 Enrollment ID: I20210427000242 |
| Provider Name | Jennifer Keil |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487233466 PECOS PAC ID: 5991114399 Enrollment ID: I20210517000454 |
| Provider Name | Jennifer Beth Katzen |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1811210271 PECOS PAC ID: 5890933998 Enrollment ID: I20210517000612 |
| Provider Name | Veronica Acuna |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457929796 PECOS PAC ID: 6608270707 Enrollment ID: I20210811003831 |
| Provider Name | Neal Anthony Zabiegalski |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1649306622 PECOS PAC ID: 2769425776 Enrollment ID: I20210831001313 |
| Provider Name | Stephanie Nelson Petrosky |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679152862 PECOS PAC ID: 0042616559 Enrollment ID: I20210909000265 |
| Provider Name | Eric Drew Yoshinaga |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649947391 PECOS PAC ID: 8123425733 Enrollment ID: I20210924000637 |
| Provider Name | Tina Ann Thomas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295402683 PECOS PAC ID: 7315344793 Enrollment ID: I20210928001413 |
| Provider Name | Marissa Velasco Jimenez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770256042 PECOS PAC ID: 7517365489 Enrollment ID: I20211006002581 |
| Provider Name | Pooja Alloju |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407527443 PECOS PAC ID: 8527466416 Enrollment ID: I20211006003488 |
| Provider Name | Raquel Garcia |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1366872343 PECOS PAC ID: 1355749292 Enrollment ID: I20211007002076 |
| Provider Name | Andrea Charvet |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922778463 PECOS PAC ID: 3476951252 Enrollment ID: I20211008000123 |
| Provider Name | Maura Nolan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447923222 PECOS PAC ID: 9739587296 Enrollment ID: I20211013002716 |
| Provider Name | Maggie Yamin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023781747 PECOS PAC ID: 3577961879 Enrollment ID: I20211015002460 |
| Provider Name | Alison Christine Bested |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1982286878 PECOS PAC ID: 4880083674 Enrollment ID: I20211117000780 |
| Provider Name | Angel Joaquin Mestre |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073279956 PECOS PAC ID: 4486043940 Enrollment ID: I20211123000522 |
| Provider Name | Ashley Cansu Ireland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497421754 PECOS PAC ID: 7719378314 Enrollment ID: I20211215000535 |
| Provider Name | Lisa Mary Presti |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1023595006 PECOS PAC ID: 1557753951 Enrollment ID: I20220114001605 |
| Provider Name | Desiree Eugenie Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356014591 PECOS PAC ID: 9739572074 Enrollment ID: I20220208002865 |
| Provider Name | Jillian Rose Yaw Ching |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1851639256 PECOS PAC ID: 8426443813 Enrollment ID: I20220322001594 |
| Provider Name | Shilpa Gaikwad |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407598493 PECOS PAC ID: 0749677508 Enrollment ID: I20220425002693 |
| Provider Name | Emilie Rose Kean |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528798071 PECOS PAC ID: 9032590492 Enrollment ID: I20220715001318 |
| Provider Name | Kimberly Perez-gutierrez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124750179 PECOS PAC ID: 3678954732 Enrollment ID: I20220720002557 |
| Provider Name | Veronia Marie Abadeer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609509165 PECOS PAC ID: 1759762701 Enrollment ID: I20220721002623 |
| Provider Name | Lena Phu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518690072 PECOS PAC ID: 7315328309 Enrollment ID: I20220721003833 |
| Provider Name | Carmen Perez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659001501 PECOS PAC ID: 8224419031 Enrollment ID: I20220725002013 |
| Provider Name | Melody Kordnaij |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669104261 PECOS PAC ID: 7517349905 Enrollment ID: I20220802000815 |
| Provider Name | Vassiliki Prattas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588334403 PECOS PAC ID: 5799182044 Enrollment ID: I20220818000114 |
| Provider Name | Chelsea Ariel Brafman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720715634 PECOS PAC ID: 6103201108 Enrollment ID: I20220912001951 |
| Provider Name | Alexia Clark |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265107213 PECOS PAC ID: 9436554961 Enrollment ID: I20221123001841 |
| Provider Name | Kevin Chase Dean |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568199727 PECOS PAC ID: 8729457072 Enrollment ID: I20221209000017 |
| Provider Name | Crystal Varela |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114650538 PECOS PAC ID: 2769851708 Enrollment ID: I20221213002606 |
| Provider Name | Patricia Barros |
|---|---|
| Provider Type | Practitioner - Oral And Maxillofacial Pathology |
| Provider Identifiers | NPI Number: 1780158667 PECOS PAC ID: 0446586309 Enrollment ID: I20230131001219 |
| Provider Name | Courtney Elizabeth Allen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114607454 PECOS PAC ID: 3577924026 Enrollment ID: I20230731002069 |
| Provider Name | Ria Shah |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982384012 PECOS PAC ID: 2668833989 Enrollment ID: I20230803000929 |
| Provider Name | Samantha Schlesman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083392815 PECOS PAC ID: 5597126722 Enrollment ID: I20230803001737 |
| Provider Name | Hsuan Chao |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730867508 PECOS PAC ID: 8527429539 Enrollment ID: I20230807001214 |
| Provider Name | Shagufta Bi Bi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285317214 PECOS PAC ID: 3072977925 Enrollment ID: I20230912001296 |
| Provider Name | Lauren Silverman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003479486 PECOS PAC ID: 5890140792 Enrollment ID: I20231012002875 |
| Provider Name | Tiffany Monet Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801676119 PECOS PAC ID: 3476909946 Enrollment ID: I20231020000236 |
| Provider Name | Annie Michelle Collett |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720864523 PECOS PAC ID: 6103272687 Enrollment ID: I20231020000699 |
| Provider Name | Karen Susan Basedow |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1013223650 PECOS PAC ID: 5799974234 Enrollment ID: I20231130001428 |
| Provider Name | Ashley Lonergan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649048059 PECOS PAC ID: 6800247701 Enrollment ID: I20240104002579 |
| Provider Name | Melinda Luis |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1104554476 PECOS PAC ID: 9537510763 Enrollment ID: I20240111002851 |
| Provider Name | Stephanie N Urban-galvez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083977359 PECOS PAC ID: 0244553071 Enrollment ID: I20240116004389 |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Southeastern University, Inc Po Box 290370, Davie, FL 33329-0370 Ph: (954) 262-4397 | Nova Southeastern University, Inc 650 North Andrews Avenue, Ft. Lauderdale, FL 33311-7436 Ph: (954) 262-4100 |
Visual Health Of Ft. Lauderdale Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2540 Ne 9 St, Ft. Lauderdale, FL 33304 Phone: 305-442-2020 Fax: 305-442-7354 | |
Dr. So Yeon Lee, O.D., FAAO Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3200 S. University Drive, Ft. Lauderdale, FL 33328 Phone: 954-262-4200 |