Basic Information
Provider Information
NPI: 1386752129
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEUFELD
FirstName: SHARI
MiddleName: JEAN
NamePrefix: DR.
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14051 SW 31ST ST
Address2:  
City: DAVIE
State: FL
PostalCode: 333304673
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7352 NW 34TH ST
Address2:  
City: MIAMI
State: FL
PostalCode: 331221266
CountryCode: US
TelephoneNumber: 3054182025
FaxNumber: 3056758195
Other Information
ProviderEnumerationDate: 08/29/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000XOPC2691FLY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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