MEDICARE: FLORIDA PHYSICIANS EYECARE GROUP, P.A.

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	:	1710469556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA PHYSICIANS EYECARE GROUP, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 24686
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-4686
Country	:	US
Telephone Number	:	561-433-6009
Fax Number	:

Provider Business Practice Location Address
First Line	:	16800 NW 67TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-4204
Country	:	US
Telephone Number	:	561-433-6009
Fax Number	:

Authorized Official
Title or Position	:	SENIOR REVENUE CYCLE MANAGER
Name	:	ALISHA JACKSON
Credential	:
Telephone Number	:	561-208-1591

Provider Enumeration Date	:	08/29/2018
Last Update Date	:	06/22/2026

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