MEDICARE: MR. STANLEY J ELBRAND OPTICIAN

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	156FX1800X	Optician	751	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033298013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STANLEY J ELBRAND OPTICIAN

Provider Business Mailing Address
First Line	:	1372 NORTHEAST 163 STREET
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4623
Country	:	US
Telephone Number	:	305-945-3361
Fax Number	:	305-945-3361

Provider Business Practice Location Address
First Line	:	1372 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4623
Country	:	US
Telephone Number	:	305-945-3361
Fax Number	:	305-945-3361

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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