MEDICARE: DR. MATTHEW CHRYCY 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	152W00000X	Optometrist	4514	FL

General Provider Information

NPI Number	:	1245546605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW CHRYCY O.D

Provider Business Mailing Address
First Line	:	1201 BRICKELL AVE
Second Line	:	STE 300
City	:	MIAMI
State	:	FL
Zip	:	33131-3207
Country	:	US
Telephone Number	:	305-905-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 BRICKELL AVE
Second Line	:	STE 300
City	:	MIAMI
State	:	FL
Zip	:	33131-3207
Country	:	US
Telephone Number	:	305-905-6900
Fax Number	:

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

Provider Enumeration Date	:	08/24/2010
Last Update Date	:	08/08/2013

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