Healthcare Provider Details

I. General information

NPI: 1801068853
Provider Name (Legal Business Name): METROPOLITAN EYE CARE SPECIALISTS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E TRAVELERS TRL SUITE D
BURNSVILLE MN
55337-6889
US

IV. Provider business mailing address

150 E TRAVELERS TRL SUITE D
BURNSVILLE MN
55337-6889
US

V. Phone/Fax

Practice location:
  • Phone: 952-894-1400
  • Fax: 952-808-2216
Mailing address:
  • Phone: 952-894-1400
  • Fax: 952-808-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY MACIK
Title or Position: PARTNER
Credential: OD
Phone: 952-894-1400