Provider Demographics
NPI:1316921679
Name:ESPOSITO, ROBERT J (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:8404 E SHEA BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6658
Mailing Address - Country:US
Mailing Address - Phone:480-483-0711
Mailing Address - Fax:480-483-8535
Practice Address - Street 1:10505 N 69TH ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-4532
Practice Address - Country:US
Practice Address - Phone:480-483-0711
Practice Address - Fax:480-483-8535
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ913152WL0500X, 152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z4900OtherHEALTHNET
AZU60460Medicare UPIN
AZZ41WCLDM05Medicare PIN
Z140245Medicare PIN