MEDICARE: EUGENIO F BIRD MD PA

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	OPC4255	FL
2	174400000X	Specialist	ME57203	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	:	1629274055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUGENIO F BIRD MD PA

Provider Business Mailing Address
First Line	:	895 OUTER ROAD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6652
Country	:	US
Telephone Number	:	407-644-4477
Fax Number	:	407-644-9549

Provider Business Practice Location Address
First Line	:	895 OUTER ROAD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6652
Country	:	US
Telephone Number	:	407-644-4477
Fax Number	:	407-644-9549

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EUGENIO F BIRD
Credential	:	MD
Telephone Number	:	407-644-4477

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	10/10/2008

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Directions to “EUGENIO F BIRD MD PA ” Practice Location

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