MEDICARE: UNIVERSITY EYE CARE 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	OPC4211	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	:	1932547403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY EYE CARE INC

Provider Business Mailing Address
First Line	:	4054 N GOLDENROD RD
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-8911
Country	:	US
Telephone Number	:	321-422-2695
Fax Number	:	321-244-4036

Provider Business Practice Location Address
First Line	:	4054 N GOLDENROD RD
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-8911
Country	:	US
Telephone Number	:	321-422-2695
Fax Number	:	321-244-4036

Authorized Official
Title or Position	:	PRESIDENT
Name	:	COLLEEN BUI
Credential	:	O.D.
Telephone Number	:	407-929-9424

Provider Enumeration Date	:	06/06/2013
Last Update Date	:	02/08/2017

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Directions to “UNIVERSITY EYE CARE INC ” Practice Location

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