Hagen, James D

Hagen, James D is an individual health care provider with primary practice located at 12979 Sw 112Th St , Miami FL 33186-4769. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Hagen, James D can be contacted via phone (305) 386-3937.

Contact Information

Primary practice address
12979 Sw 112Th St Miami FL 33186-4769
Phone: (305) 386-3937
Fax: (305) 386-1494
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X FL1745 Florida

Profile Details

NPI number 1396723219
LBN Legal business name Hagen, James D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Dec 3rd, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396723219 NPPES
Florida MEDICAID 078357900

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