MEDICARE: MM EYECARE CONSULTANTS, 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	332H00000X	Eyewear Supplier
2	152W00000X	Optometrist

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	:	1801371539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MM EYECARE CONSULTANTS, INC

Provider Business Mailing Address
First Line	:	1949 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4403
Country	:	US
Telephone Number	:	786-391-1303
Fax Number	:	786-391-1240

Provider Business Practice Location Address
First Line	:	1949 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4403
Country	:	US
Telephone Number	:	786-391-1301
Fax Number	:	786-391-1240

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MANUEL MUNIZ
Credential	:	OD
Telephone Number	:	786-391-1303

Provider Enumeration Date	:	09/28/2018
Last Update Date	:	12/16/2020

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