Provider Demographics
NPI:1215104765
Name:BREZINA, JULIA DUBE (LIC DISP OPTICIAN)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:DUBE
Last Name:BREZINA
Suffix:
Gender:F
Credentials:LIC DISP OPTICIAN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3200 SW 60TH CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4069
Mailing Address - Country:US
Mailing Address - Phone:305-662-8277
Mailing Address - Fax:305-661-7862
Practice Address - Street 1:3200 SW 60TH CT
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4069
Practice Address - Country:US
Practice Address - Phone:305-662-8277
Practice Address - Fax:305-661-7862
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDO1167156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician