MEDICARE: DR. LAURA MARIE DEMARCO 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	152WL0500X	Low Vision Rehabilitation Optometrist	OPC3552	FL
2	152W00000X	Optometrist	OPC3552	FL
3	152WC0802X	Corneal and Contact Management Optometrist	OPC3552	FL

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	:	1437276243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA MARIE DEMARCO O.D.

Provider Business Mailing Address
First Line	:	PO BOX 970543
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33497-0543
Country	:	US
Telephone Number	:	561-271-4962
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 S POWERLINE RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4311
Country	:	US
Telephone Number	:	954-977-6636
Fax Number	:

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

Provider Enumeration Date	:	03/25/2007
Last Update Date	:	01/19/2017

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