MEDICARE: BEST OPHTHALMOLOGY GROUP.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

General Provider Information

NPI Number	:	1295191906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEST OPHTHALMOLOGY GROUP.INC

Provider Business Mailing Address
First Line	:	7211 N DALE MABRY HWY STE 222
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-2669
Country	:	US
Telephone Number	:	813-402-0798
Fax Number	:

Provider Business Practice Location Address
First Line	:	7211 N DALE MABRY HWY STE 222
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-2669
Country	:	US
Telephone Number	:	813-402-0798
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. GONZALO RODRIGUEZ
Credential	:
Telephone Number	:	305-330-4840

Provider Enumeration Date	:	01/11/2016
Last Update Date	:	01/11/2016

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