MEDICARE: DR. ALAN O MARAMARA OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC2476	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20252V	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366557639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN O MARAMARA OD

Provider Business Mailing Address
First Line	:	WEST COAST MOBILE EYE CARE
Second Line	:	P. O. BOX 39
City	:	RUSKIN
State	:	FL
Zip	:	33575-0039
Country	:	US
Telephone Number	:	813-886-2020
Fax Number	:	813-886-7222

Provider Business Practice Location Address
First Line	:	25 COLLEGE AVE. W
Second Line	:	STE D
City	:	RUSKIN
State	:	FL
Zip	:	33570-4701
Country	:	US
Telephone Number	:	813-886-2020
Fax Number	:	813-886-7222

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	12/20/2013

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