MEDICARE: ADVANCED EYE CENTERS FR LLC

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

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	:	1114291994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED EYE CENTERS FR LLC

Provider Business Mailing Address
First Line	:	500 FAUNCE CORNER RD
Second Line	:	SUITE 110
City	:	N DARTMOUTH
State	:	MA
Zip	:	02747-1278
Country	:	US
Telephone Number	:	508-717-0270
Fax Number	:	508-995-3060

Provider Business Practice Location Address
First Line	:	1741 PRESIDENT AVE
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-7113
Country	:	US
Telephone Number	:	508-674-2020
Fax Number	:	508-536-4766

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PAUL C ABRANTES
Credential	:
Telephone Number	:	508-717-0270

Provider Enumeration Date	:	02/27/2012
Last Update Date	:	07/22/2014

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