Basic Information
| Provider Information | |||||||||
| NPI: | 1629059381 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STERN | ||||||||
| FirstName: | JODI | ||||||||
| MiddleName: | LYN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7352 NW 34TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054182025 | ||||||||
| FaxNumber: | 3054189882 | ||||||||
| Practice Location | |||||||||
| Address1: | 7352 NW 34TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054182025 | ||||||||
| FaxNumber: | 3054189882 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2005 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPC002748 | FL | X | Eye and Vision Services Providers | Optometrist | 152WC0802X | OPC002748 | FL | X | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management | 152WL0500X | OPC002748 | FL | X | Eye and Vision Services Providers | Optometrist | Low Vision Rehabilitation | 152WP0200X | OPC02748 | FL | X | Eye and Vision Services Providers | Optometrist | Pediatrics | 152WS0006X | OPC002748 | FL | X | Eye and Vision Services Providers | Optometrist | Sports Vision | 152WV0400X | OPC002748 | FL | X | Eye and Vision Services Providers | Optometrist | Vision Therapy | 152WX0102X | OPC002748 | FL | X | Eye and Vision Services Providers | Optometrist | Occupational Vision |
No ID Information.