MEDICARE: MORAN & MAURI EYE CENTER 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	OPC864	FL

General Provider Information

NPI Number	:	1770782203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORAN & MAURI EYE CENTER PA

Provider Business Mailing Address
First Line	:	15332 NW 79TH CT
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5808
Country	:	US
Telephone Number	:	305-821-0304
Fax Number	:	305-558-0641

Provider Business Practice Location Address
First Line	:	15332 NW 79TH CT
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5808
Country	:	US
Telephone Number	:	305-821-0304
Fax Number	:	305-558-0641

Authorized Official
Title or Position	:	DIRECTOR/OPTOMETRIST
Name	:	DR. RAMON MORAN JR.
Credential	:	O.D.
Telephone Number	:	305-821-0304

Provider Enumeration Date	:	07/14/2007
Last Update Date	:	09/21/2010

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