MEDICARE: EYE CARE AND SURGERY CENTER OF FT. LAUDERDALE, LLC

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	261Q00000X	Clinic/Center	1004	FL
2	261QA1903X	Ambulatory Surgical Clinic/Center	1004	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	:	1467458281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CARE AND SURGERY CENTER OF FT. LAUDERDALE, LLC

Provider Business Mailing Address
First Line	:	1097 S LE JEUNE RD FL 2
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2639
Country	:	US
Telephone Number	:	305-442-2020
Fax Number	:	305-442-7354

Provider Business Practice Location Address
First Line	:	2540 NE 9TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3525
Country	:	US
Telephone Number	:	305-442-2020
Fax Number	:	305-442-7354

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	ALBERTO J. ARAN
Credential	:	MD
Telephone Number	:	305-442-2020

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	06/19/2024

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