MEDICARE: MITTLEMAN EYE CENTER PA

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

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	:	1518097401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MITTLEMAN EYE CENTER PA

Provider Business Mailing Address
First Line	:	2000 PALM BEACH LAKES BLVD
Second Line	:	SUITE 400
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6504
Country	:	US
Telephone Number	:	561-478-2015
Fax Number	:	561-478-1300

Provider Business Practice Location Address
First Line	:	2000 PALM BEACH LAKES BLVD
Second Line	:	SUITE 400
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6504
Country	:	US
Telephone Number	:	561-478-2015
Fax Number	:	561-478-1300

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	HUGH GLATTS
Credential	:
Telephone Number	:	561-478-2015

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	08/13/2013

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Directions to “MITTLEMAN EYE CENTER PA ” Practice Location

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