MEDICARE: BRICELAND ENTERPRISES PLC

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	174400000X	Specialist	19009	AZ
2	156FX1100X	Ophthalmic Technician/Technologist	18851	AZ

General Provider Information

NPI Number	:	1538496294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRICELAND ENTERPRISES PLC

Provider Business Mailing Address
First Line	:	13624 W CAMINO DEL SOL STE 200
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-3401
Country	:	US
Telephone Number	:	623-546-2020
Fax Number	:	623-546-2399

Provider Business Practice Location Address
First Line	:	13624 W CAMINO DEL SOL STE 200
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-3401
Country	:	US
Telephone Number	:	623-546-2020
Fax Number	:	623-546-2399

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DANIEL J BRICELAND
Credential	:	M.D.
Telephone Number	:	623-546-2020

Provider Enumeration Date	:	11/17/2009
Last Update Date	:	11/17/2009

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Directions to “BRICELAND ENTERPRISES PLC ” Practice Location

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