Provider Demographics
NPI:1730428368
Name:SMIRNOVA, DARYANA (OD)
Entity type:Individual
Prefix:DR
First Name:DARYANA
Middle Name:
Last Name:SMIRNOVA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19575 BISCAYNE BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2309
Mailing Address - Country:US
Mailing Address - Phone:305-933-1745
Mailing Address - Fax:
Practice Address - Street 1:19575 BISCAYNE BLVD STE 107
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2309
Practice Address - Country:US
Practice Address - Phone:305-933-1745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007946152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No152W00000XEye and Vision Services ProvidersOptometrist