MEDICARE: MEDEYE SURGERY CENTER, 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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1538615828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDEYE SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	6660 SW 117 AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183
Country	:	US
Telephone Number	:	305-661-8588
Fax Number	:

Provider Business Practice Location Address
First Line	:	6660 SW 117 AVE
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33183
Country	:	US
Telephone Number	:	305-661-8588
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MEDICAL DIRECTOR
Name	:	DR. ALAN JAMES SEGAL
Credential	:	MD
Telephone Number	:	305-661-8588

Provider Enumeration Date	:	08/28/2016
Last Update Date	:	09/23/2016

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