Provider Demographics
NPI:1962885756
Name:PETERSEN & PETRESCU ASSOC.LLC
Entity type:Organization
Organization Name:PETERSEN & PETRESCU ASSOC.LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OM
Authorized Official - Prefix:
Authorized Official - First Name:VIORICA
Authorized Official - Middle Name:ANDRONACHE
Authorized Official - Last Name:PETRESCU PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:954-647-4689
Mailing Address - Street 1:3800 S OCEAN DR
Mailing Address - Street 2:G-9
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019
Mailing Address - Country:US
Mailing Address - Phone:954-456-3808
Mailing Address - Fax:954-454-1012
Practice Address - Street 1:3800 S OCEAN DR
Practice Address - Street 2:G-9
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-2927
Practice Address - Country:US
Practice Address - Phone:954-456-3808
Practice Address - Fax:954-454-1012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty