Provider Demographics
NPI:1285080515
Name:DR. STEPHEN HOUGHTON & ASSOCIATES
Entity type:Organization
Organization Name:DR. STEPHEN HOUGHTON & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:305-273-7790
Mailing Address - Street 1:12640 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1868
Mailing Address - Country:US
Mailing Address - Phone:305-273-7790
Mailing Address - Fax:305-273-4330
Practice Address - Street 1:12640 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1868
Practice Address - Country:US
Practice Address - Phone:305-273-7790
Practice Address - Fax:305-273-4330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1054152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL621001500Medicaid