Healthcare Provider Details

I. General information

NPI: 1497430532
Provider Name (Legal Business Name): RETINA MACULA SPECIALISTS OF MIAMI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2466 E COMMERCIAL BLVD STE 102
FT LAUDERDALE FL
33308-4011
US

IV. Provider business mailing address

184 NE 168TH ST
N MIAMI BEACH FL
33162-3412
US

V. Phone/Fax

Practice location:
  • Phone: 954-492-1177
  • Fax: 954-492-0352
Mailing address:
  • Phone: 305-655-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAY HARRIS LEVY
Title or Position: PARTNER
Credential: MD
Phone: 305-653-6500