Provider Demographics
NPI:1538299201
Name:EVANS, MIRIAM TENDLER (OD)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:TENDLER
Last Name:EVANS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:20780 SNUG CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6824
Mailing Address - Country:US
Mailing Address - Phone:561-852-9190
Mailing Address - Fax:561-852-9190
Practice Address - Street 1:1375 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-5884
Practice Address - Country:US
Practice Address - Phone:954-641-3777
Practice Address - Fax:954-792-7428
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2009-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL2666152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist