MEDICARE: VISION THE EYE CARE CENTER, PA

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	ME92734	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K9317	OTHER	FL	MEDICARE GROUP NUMBER

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

General Provider Information

NPI Number	:	1659557890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION THE EYE CARE CENTER, PA

Provider Business Mailing Address
First Line	:	6320 FOREST HILL BLVD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33415-6104
Country	:	US
Telephone Number	:	561-228-8882
Fax Number	:	561-357-3387

Provider Business Practice Location Address
First Line	:	6320 FOREST HILL BLVD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33415-6104
Country	:	US
Telephone Number	:	561-228-8882
Fax Number	:	561-357-3387

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDGAR R CACERES
Credential	:	MD
Telephone Number	:	561-228-8882

Provider Enumeration Date	:	01/17/2008
Last Update Date	:	01/17/2008

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Directions to “VISION THE EYE CARE CENTER, PA ” Practice Location

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