MEDICARE: MIAMI REGIONAL EYE CARE, 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	207W00000X	Ophthalmology Physician		OH

General Provider Information

NPI Number	:	1942441977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI REGIONAL EYE CARE, INC.

Provider Business Mailing Address
First Line	:	180 S STANFIELD RD
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-0106
Country	:	US
Telephone Number	:	937-335-9020
Fax Number	:	937-335-6684

Provider Business Practice Location Address
First Line	:	180 S STANFIELD RD
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-0106
Country	:	US
Telephone Number	:	937-335-9020
Fax Number	:	937-335-6684

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	JAMES ROBERT RADEMACHER
Credential	:	M.D.
Telephone Number	:	937-335-9020

Provider Enumeration Date	:	03/22/2009
Last Update Date	:	03/22/2009

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