MEDICARE: EL RETORNO OPTICAL VISION, 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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1538397195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL RETORNO OPTICAL VISION, INC.

Provider Business Mailing Address
First Line	:	11750 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2102
Country	:	US
Telephone Number	:	305-274-8821
Fax Number	:	305-274-8841

Provider Business Practice Location Address
First Line	:	11750 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2102
Country	:	US
Telephone Number	:	305-274-8821
Fax Number	:	305-274-8841

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. DALIA LURBE
Credential	:
Telephone Number	:	305-274-8821

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	06/23/2009

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