Provider Demographics
NPI:1316521271
Name:SUSAN HOPPER OD PA
Entity type:Organization
Organization Name:SUSAN HOPPER OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPPER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-298-0930
Mailing Address - Street 1:10835 SW 52ND DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6966
Mailing Address - Country:US
Mailing Address - Phone:305-298-0930
Mailing Address - Fax:
Practice Address - Street 1:897 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-5021
Practice Address - Country:US
Practice Address - Phone:305-245-7419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty