MEDICARE: DR. JORDAN MILES KAY O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	1757	FL

General Provider Information

NPI Number	:	1013082494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN MILES KAY O.D.

Provider Business Mailing Address
First Line	:	5621 COACH HOUSE CIR
Second Line	:	SUITE B
City	:	BOCA RATON
State	:	FL
Zip	:	33486-8686
Country	:	US
Telephone Number	:	561-362-9849
Fax Number	:	239-275-3780

Provider Business Practice Location Address
First Line	:	4125 CLEVELAND AVE
Second Line	:	SUITE #113
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9046
Country	:	US
Telephone Number	:	239-939-5393
Fax Number	:	239-275-3780

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	07/08/2007

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