MEDICARE: PALM BEACH GARDENS EYE DOCTOR 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

General Provider Information

NPI Number	:	1811849276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM BEACH GARDENS EYE DOCTOR INC

Provider Business Mailing Address
First Line	:	295 QUEENS CT
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7323
Country	:	US
Telephone Number	:	561-799-3932
Fax Number	:

Provider Business Practice Location Address
First Line	:	7100 FAIRWAY DR STE 39
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4203
Country	:	US
Telephone Number	:	561-799-3932
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL NODLAND
Credential	:	OD
Telephone Number	:	954-592-3557

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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