MEDICARE: HIALEAH EYE CARE CORP

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578786729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIALEAH EYE CARE CORP

Provider Business Mailing Address
First Line	:	5370 PALM AVE
Second Line	:	SUITE 2
City	:	HIALEAH
State	:	FL
Zip	:	33012
Country	:	US
Telephone Number	:	305-820-9771
Fax Number	:	305-820-9771

Provider Business Practice Location Address
First Line	:	5370 PALM AVE
Second Line	:	SUITE 2
City	:	HIALEAH
State	:	FL
Zip	:	33012-2766
Country	:	US
Telephone Number	:	305-820-9771
Fax Number	:	305-820-9771

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BELKIS BOSCH
Credential	:
Telephone Number	:	305-820-9771

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	12/20/2013

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Directions to “HIALEAH EYE CARE CORP ” Practice Location

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