MEDICARE: DRESNER EYE CARE LLC

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	207W00000X	Ophthalmology Physician	ME0055925	FL

General Provider Information

NPI Number	:	1629065966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRESNER EYE CARE LLC

Provider Business Mailing Address
First Line	:	8045 SPYGLASS HILL ROAD
Second Line	:	SUITE 105
City	:	VIERA
State	:	FL
Zip	:	32940-7984
Country	:	US
Telephone Number	:	321-253-1919
Fax Number	:

Provider Business Practice Location Address
First Line	:	8045 SPYGLASS HILL ROAD
Second Line	:	SUITE 105
City	:	VIERA
State	:	FL
Zip	:	32940-7984
Country	:	US
Telephone Number	:	321-253-1919
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK DRESNER
Credential	:	M.D.
Telephone Number	:	321-253-1919

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	08/22/2020

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