Healthcare Provider Details

I. General information

NPI: 1871919043
Provider Name (Legal Business Name): RETINA MACULA SPECIALISTS OF MIAMI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 N COMMERCE PKWY STE 110
WESTON FL
33326-3258
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 954-452-9922
  • Fax: 544-527-5749
Mailing address:
  • Phone: 305-655-0411
  • Fax: 305-655-0499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME86697
License Number StateFL

VIII. Authorized Official

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