Basic Information
| Provider Information | |||||||||
| NPI: | 1881349645 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ONE OCULOPLASTICS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 888 BRICKELL KEY DR APT 710 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331312663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619017303 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2441 SW 37TH AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331453051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054420066 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2022 | ||||||||
| LastUpdateDate: | 02/19/2022 | ||||||||
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| AuthorizedOfficialLastName: | AVILA | ||||||||
| AuthorizedOfficialFirstName: | SARAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 5619017303 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207WX0200X | Y | 193400000X SINGLE SPECIALTY GROUP |
No ID Information.