Basic Information
Provider Information
NPI: 1154662427
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALUWIESI
FirstName: ORNELLA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: O. D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1950 OLD GALLOWS RD
Address2: SUITE 520
City: VIENNA
State: VA
PostalCode: 221823990
CountryCode: US
TelephoneNumber: 7038478899
FaxNumber: 7039910514
Practice Location
Address1: 1251 LAKELAND HILLS BLVD
Address2:  
City: LAKELAND
State: FL
PostalCode: 338054673
CountryCode: US
TelephoneNumber: 8636872260
FaxNumber: 8635950927
Other Information
ProviderEnumerationDate: 03/11/2013
LastUpdateDate: 10/24/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X0618002213VAN Eye and Vision Services ProvidersOptometrist 
152W00000XOPC5299FLY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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