MEDICARE: EYE CENTERS OF CLEVELAND, INC

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	207W00000X	Ophthalmology Physician	35097311	OH

General Provider Information

NPI Number	:	1083017644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CENTERS OF CLEVELAND, INC

Provider Business Mailing Address
First Line	:	12000 MCCRACKEN RD STE 215
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-2933
Country	:	US
Telephone Number	:	216-581-6111
Fax Number	:

Provider Business Practice Location Address
First Line	:	12000 MCCRACKEN RD STE 215
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-2933
Country	:	US
Telephone Number	:	216-581-6111
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/PHYSICIAN
Name	:	GEORGE ARISTOTLE MARKAKIS
Credential	:	M.D.
Telephone Number	:	216-581-6111

Provider Enumeration Date	:	09/26/2014
Last Update Date	:	06/22/2015

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