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General NPI Number Information
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NPI Number | 1013128263
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Entity Type | Organization
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Legal Business Name | K.M.EYE, P.A.
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Dates
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Enumeration Date | 05/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5333 N DIXIE HWY 101
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3414
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Country | US
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Telephone | 954-493-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 5333 N DIXIE HWY 101
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3414
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Country | US
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Telephone | 954-493-5052
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH MALLER
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Credential | O.D.
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Telephone | 954-493-5052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC2541
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License Number State | FL
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