MEDICARE: WORLD OPTICAL II 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	920528784811	OTHER	FL	CCN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578549259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORLD OPTICAL II INC

Provider Business Mailing Address
First Line	:	8828 W STATE ROAD 84
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33324-4415
Country	:	US
Telephone Number	:	954-916-8484
Fax Number	:	954-476-2668

Provider Business Practice Location Address
First Line	:	8828 W STATE ROAD 84
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33324-4415
Country	:	US
Telephone Number	:	954-916-8484
Fax Number	:	954-476-2668

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RUSK S HARRIS
Credential	:	OD
Telephone Number	:	954-916-8484

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	06/20/2008

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Directions to “WORLD OPTICAL II INC ” Practice Location

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