MEDICARE: NORTH PORT EYE CARE 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	152W00000X	Optometrist	OPC3940	FL

General Provider Information

NPI Number	:	1457699134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH PORT EYE CARE INC.

Provider Business Mailing Address
First Line	:	17000 TAMIAMI TRL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-7281
Country	:	US
Telephone Number	:	941-429-1430
Fax Number	:	941-423-8952

Provider Business Practice Location Address
First Line	:	17000 TAMIAMI TRL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-7281
Country	:	US
Telephone Number	:	941-429-1430
Fax Number	:	941-423-8952

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEFANO RAGOZZINO
Credential	:	O.D.
Telephone Number	:	941-525-4771

Provider Enumeration Date	:	01/30/2013
Last Update Date	:	01/30/2013

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