Basic Information
| Provider Information | |||||||||
| NPI: | 1861875510 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AWADA | ||||||||
| FirstName: | YASMEEN | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1505 FORT CLARKE BLVD APT 10207 | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326069117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195092734 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1040 CYPRESS PKWY | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347593328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079332088 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2015 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | OPC 5096 | FL | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.