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General NPI Number Information
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NPI Number | 1801371539
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Entity Type | Organization
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Legal Business Name | MM EYECARE CONSULTANTS, INC
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Dates
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Enumeration Date | 09/28/2018
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 1949 W 68TH ST
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City | HIALEAH
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State | FL
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Zip | 33014-4403
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Country | US
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Telephone | 786-391-1301
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Fax | 786-391-1240
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Provider Business Mailing Address
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Address Line | 1949 W 68TH ST
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City | HIALEAH
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State | FL
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Zip | 33014-4403
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Country | US
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Telephone | 786-391-1303
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Fax | 786-391-1240
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANUEL MUNIZ
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Credential | OD
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Telephone | 786-391-1303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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