Basic Information
Provider Information
NPI: 1184058174
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANKEL
FirstName: STEPHANIE
MiddleName: THERESA
NamePrefix: DR.
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 900 NW 17TH ST
Address2:  
City: MIAMI
State: FL
PostalCode: 331361119
CountryCode: US
TelephoneNumber: 3052432020
FaxNumber:  
Practice Location
Address1: 900 NW 17TH ST
Address2:  
City: MIAMI
State: FL
PostalCode: 331361119
CountryCode: US
TelephoneNumber: 3052432020
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/26/2013
LastUpdateDate: 03/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X4796FLN Eye and Vision Services ProvidersOptometrist 
152W00000XOPC4796FLY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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