MEDICARE: STELZER OPTOMETRIC 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	152W00000X	Optometrist	OPC4244	FL

General Provider Information

NPI Number	:	1972775468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STELZER OPTOMETRIC LLC

Provider Business Mailing Address
First Line	:	6000 INDIAN CREEK DR
Second Line	:	APT. 1602
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2356
Country	:	US
Telephone Number	:	941-920-2106
Fax Number	:	305-461-9633

Provider Business Practice Location Address
First Line	:	6000 INDIAN CREEK DR
Second Line	:	APT. 1602
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2356
Country	:	US
Telephone Number	:	941-920-2106
Fax Number	:	305-461-9633

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. ADAM LOUIS STELZER
Credential	:	O.D.
Telephone Number	:	941-920-2106

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	10/07/2010

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