MEDICARE: OPTICAL EYEWORKS INC

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	156FX1800X	Optician	FL1906	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1386788602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTICAL EYEWORKS INC

Provider Business Mailing Address
First Line	:	8124 WILES RD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2061
Country	:	US
Telephone Number	:	954-757-2468
Fax Number	:	954-757-2456

Provider Business Practice Location Address
First Line	:	8124 WILES RD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2061
Country	:	US
Telephone Number	:	954-757-2468
Fax Number	:	954-757-2456

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOEL WILK
Credential	:
Telephone Number	:	954-757-2468

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	07/25/2008

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Directions to “OPTICAL EYEWORKS INC ” Practice Location

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