MEDICARE: DR. CARL L MILOVAC O.D.

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	OPC4040	FL

General Provider Information

NPI Number	:	1588668438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL L MILOVAC O.D.

Provider Business Mailing Address
First Line	:	10401-334 SOUTH HWY 441
Second Line	:
City	:	LEESBURG
State	:	FL
Zip	:	34788-2522
Country	:	US
Telephone Number	:	352-326-2416
Fax Number	:	352-728-0509

Provider Business Practice Location Address
First Line	:	10401-334 SOUTH HWY 441
Second Line	:
City	:	LEESBURG
State	:	FL
Zip	:	34788-2522
Country	:	US
Telephone Number	:	352-326-2416
Fax Number	:	352-728-0509

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	03/15/2013

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