Provider Demographics
NPI:1215505755
Name:FORJAN, NATALIA ISABEL (OD)
Entity type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:ISABEL
Last Name:FORJAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:NATALIA
Other - Middle Name:ISABEL
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5030 SW 113TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6059
Mailing Address - Country:US
Mailing Address - Phone:786-546-0896
Mailing Address - Fax:
Practice Address - Street 1:10521 N KENDALL DRIVE
Practice Address - Street 2:#E103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-279-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5929152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist