Provider Demographics
NPI:1376166025
Name:MIAMI EYE PROFESSIONALS
Entity Type:Organization
Organization Name:MIAMI EYE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MACEDO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-776-2343
Mailing Address - Street 1:765 NE 96TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2519
Mailing Address - Country:US
Mailing Address - Phone:305-776-2343
Mailing Address - Fax:
Practice Address - Street 1:2320 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1525
Practice Address - Country:US
Practice Address - Phone:305-649-4011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty