MEDICARE: DUNES EYE CARE, LLC

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
2	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1760189047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUNES EYE CARE, LLC

Provider Business Mailing Address
First Line	:	8210B DEVON CT
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-4178
Country	:	US
Telephone Number	:	214-912-6207
Fax Number	:

Provider Business Practice Location Address
First Line	:	8210B DEVON CT
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-4178
Country	:	US
Telephone Number	:	214-912-6207
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS J D'ORAZIO
Credential	:	MD
Telephone Number	:	214-912-6207

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	12/14/2023

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