MEDICARE: M & C OPTICS 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	156FX1800X	Optician	DO1568	FL

General Provider Information

NPI Number	:	1942478557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M & C OPTICS LLC

Provider Business Mailing Address
First Line	:	4530 PGA BLVD
Second Line	:	STE 105
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3912
Country	:	US
Telephone Number	:	561-622-1388
Fax Number	:	561-622-2408

Provider Business Practice Location Address
First Line	:	4530 PGA BLVD
Second Line	:	STE 105
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3912
Country	:	US
Telephone Number	:	561-622-1388
Fax Number	:	561-622-2408

Authorized Official
Title or Position	:	OPTICIAN
Name	:	RICHARD C COOPERSTEIN
Credential	:
Telephone Number	:	561-622-1388

Provider Enumeration Date	:	02/16/2008
Last Update Date	:	06/11/2009

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Directions to “M & C OPTICS LLC ” Practice Location

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