Provider Demographics
NPI:1104897933
Name:CAPORELLI, JILL (OD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:CAPORELLI
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 1:2340 W 24TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6239
Mailing Address - Country:US
Mailing Address - Phone:928-246-2438
Mailing Address - Fax:928-329-9678
Practice Address - Street 1:2340 W 24TH ST
Practice Address - Street 2:ADOBE EYECARE CENTER PLLC
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6231
Practice Address - Country:US
Practice Address - Phone:928-329-9685
Practice Address - Fax:928-329-9678
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOD818152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U47353Medicare UPIN
AZZ70559Medicare PIN