Provider Demographics
NPI:1053794628
Name:LARGO PIEDRA, MILEIDY (OD)
Entity type:Individual
Prefix:DR
First Name:MILEIDY
Middle Name:
Last Name:LARGO PIEDRA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MILEIDY
Other - Middle Name:
Other - Last Name:LARGO PIEDRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:8590 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2336
Mailing Address - Country:US
Mailing Address - Phone:305-223-2880
Mailing Address - Fax:
Practice Address - Street 1:8590 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2336
Practice Address - Country:US
Practice Address - Phone:305-223-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist