MEDICARE: ONLY FOR EYES

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	156FX1800X	Optician	DA 5767	FL

General Provider Information

NPI Number	:	1568471225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONLY FOR EYES

Provider Business Mailing Address
First Line	:	800 E HALLANDALE BEACH BLVD STE 9
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4475
Country	:	US
Telephone Number	:	954-456-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 E HALLANDALE BEACH BLVD STE 9
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4475
Country	:	US
Telephone Number	:	954-456-7200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. DIANA A REASON
Credential	:
Telephone Number	:	954-456-7200

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	01/11/2008

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Directions to “ONLY FOR EYES ” Practice Location

Language	Start Address	Practice Location

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