MEDICARE: PREMIER EYE CENTER 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	OPC4614	FL

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	:	1831436146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER EYE CENTER INC

Provider Business Mailing Address
First Line	:	3650 FOREST HILL BLVD STE 2
Second Line	:	SUITE 2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5662
Country	:	US
Telephone Number	:	561-964-1359
Fax Number	:	561-964-8771

Provider Business Practice Location Address
First Line	:	3650 FOREST HILL BLVD STE 2
Second Line	:	SUITE 2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5662
Country	:	US
Telephone Number	:	561-964-1359
Fax Number	:	561-964-8771

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. ALEXANDRA KEHOE
Credential	:	O.D.
Telephone Number	:	561-964-1359

Provider Enumeration Date	:	01/07/2013
Last Update Date	:	03/25/2013

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Directions to “PREMIER EYE CENTER INC ” Practice Location

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