MEDICARE: DR. MILTON RICHARD HEARING OD

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	OPC1927	FL

General Provider Information

NPI Number	:	1255392239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILTON RICHARD HEARING OD

Provider Business Mailing Address
First Line	:	44 BARKLEY CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7530
Country	:	US
Telephone Number	:	239-985-7171
Fax Number	:	239-985-7118

Provider Business Practice Location Address
First Line	:	2889 10TH AVE N
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-3045
Country	:	US
Telephone Number	:	239-985-7171
Fax Number	:	239-985-7118

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

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	10/24/2023

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