Healthcare Provider Details

I. General information

NPI: 1275440950
Provider Name (Legal Business Name): RETINA MACULA SPECIALISTS OF MIAMI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 NW 95TH ST STE 412
MIAMI FL
33150-2067
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 305-651-4300
  • Fax:
Mailing address:
  • Phone: 305-651-4300
  • 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: MANAGING PARTNER
Credential:
Phone: 305-653-6500