MEDICARE: MR. MAURICE WILLIAM GILBERT OPTICIAN

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	DO 0002672	FL

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	:	1588614663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MAURICE WILLIAM GILBERT OPTICIAN

Provider Business Mailing Address
First Line	:	RUSH OPTICAL, INC
Second Line	:	1644 NE 164 STREET
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4017
Country	:	US
Telephone Number	:	305-945-3615
Fax Number	:	305-940-2065

Provider Business Practice Location Address
First Line	:	1644 NE 164TH ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4017
Country	:	US
Telephone Number	:	305-945-3615
Fax Number	:	305-940-2065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	12/26/2007

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