IndividualActive
Elissage Jean-Baptiste, LICENSED OPTICIAN
NPI 1922865823 · Occupational Vision Optometrist · Sunrise, FL
Provider details
- NPI number
- 1922865823
- Entity type
- Individual
- Primary specialty
- Occupational Vision OptometristEye and Vision Services Providers
- Credential
- LICENSED OPTICIAN
- Sex
- Male
- Sole proprietor
- Yes
- License
- 5135 (FL)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
12555 W Sunrise Blvd
Sunrise, FL 33323-0900
Phone: (954) 845-0647
Fax: (954) 845-0289
Approximate (ZIP-level) locationGet directions
Mailing address
18572 Sw 42nd St
Miramar, FL 33029-2774
Registry dates
- Enumerated
- 2024-03-06
- Last updated
- 2024-03-06
- Certified
- 2024-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.