MEDICARE: GREENACRES EYE ASSOCIATES 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

General Provider Information

NPI Number	:	1851156699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENACRES EYE ASSOCIATES PA

Provider Business Mailing Address
First Line	:	15229 73RD TERRACE N
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418
Country	:	US
Telephone Number	:	843-742-1006
Fax Number	:

Provider Business Practice Location Address
First Line	:	5493 10TH AVE N
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-2056
Country	:	US
Telephone Number	:	843-742-1006
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENJAMIN BITTNER
Credential	:	OD
Telephone Number	:	843-742-1006

Provider Enumeration Date	:	02/20/2024
Last Update Date	:	02/20/2024

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