MEDICARE: ANGEL EYE CARE, 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	OPC3826	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	:	1629300223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL EYE CARE, INC

Provider Business Mailing Address
First Line	:	10524 SW 132ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-3443
Country	:	US
Telephone Number	:	305-992-2825
Fax Number	:

Provider Business Practice Location Address
First Line	:	10524 SW 132ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-3443
Country	:	US
Telephone Number	:	305-992-2825
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LISA JEANINE RAMIREZ
Credential	:	O.D.
Telephone Number	:	305-992-2825

Provider Enumeration Date	:	02/05/2010
Last Update Date	:	02/05/2010

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Directions to “ANGEL EYE CARE, INC ” Practice Location

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