Provider Demographics
NPI:1174913362
Name:DR RICHARD H MYERS OPTOMETRIST
Entity type:Organization
Organization Name:DR RICHARD H MYERS OPTOMETRIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-220-7555
Mailing Address - Street 1:8410 W FLAGLER ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2092
Mailing Address - Country:US
Mailing Address - Phone:305-220-7555
Mailing Address - Fax:305-220-6020
Practice Address - Street 1:8410 W FLAGLER ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2092
Practice Address - Country:US
Practice Address - Phone:305-220-7555
Practice Address - Fax:305-220-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1240152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty