MEDICARE: KESSELMAN 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	OPC4993	FL

General Provider Information

NPI Number	:	1518339407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KESSELMAN EYE CARE INC

Provider Business Mailing Address
First Line	:	16900 N BAY RD
Second Line	:	APT 609
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-4252
Country	:	US
Telephone Number	:	305-998-9950
Fax Number	:	305-998-9955

Provider Business Practice Location Address
First Line	:	14711 BISCAYNE BLVD
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-1213
Country	:	US
Telephone Number	:	305-998-9950
Fax Number	:	305-998-9955

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH A KESSELMAN
Credential	:	O.D.
Telephone Number	:	305-998-9950

Provider Enumeration Date	:	10/30/2015
Last Update Date	:	10/30/2015

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