MEDICARE: SUNSET EYES OPTICAL

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1235489204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSET EYES OPTICAL

Provider Business Mailing Address
First Line	:	9638 SW 72ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3250
Country	:	US
Telephone Number	:	305-412-4840
Fax Number	:	305-412-4839

Provider Business Practice Location Address
First Line	:	9638 SW 72ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3250
Country	:	US
Telephone Number	:	305-412-4840
Fax Number	:	305-412-4839

Authorized Official
Title or Position	:	OWNER
Name	:	MARK HUNTER
Credential	:	OPTICIAN
Telephone Number	:	305-412-4840

Provider Enumeration Date	:	09/17/2012
Last Update Date	:	09/17/2012

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Directions to “SUNSET EYES OPTICAL ” Practice Location

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