MEDICARE: SUNSHINE EYE CARE PLLC

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

General Provider Information

NPI Number	:	1598052730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE EYE CARE PLLC

Provider Business Mailing Address
First Line	:	101 BRINY AVE
Second Line	:	APT. 2509
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-5661
Country	:	US
Telephone Number	:	785-213-5715
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 S POWERLINE RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4311
Country	:	US
Telephone Number	:	954-977-6636
Fax Number	:

Authorized Official
Title or Position	:	SOLE MBR
Name	:	DR. HEATHER SCHAFFER
Credential	:	O.D.
Telephone Number	:	785-213-5715

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	07/08/2011

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