Provider Demographics
NPI:1710429089
Name:NOOR, TASNIM (OD)
Entity type:Individual
Prefix:
First Name:TASNIM
Middle Name:
Last Name:NOOR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8021 PETERS RD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4053
Mailing Address - Country:US
Mailing Address - Phone:954-224-8642
Mailing Address - Fax:
Practice Address - Street 1:2471 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6853
Practice Address - Country:US
Practice Address - Phone:954-943-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.011073152W00000X
NY008743152W00000X
NJ27OA00678900152W00000X
FLFL5986152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist