# 1162 MILITARY TRAIL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Laser Eye Center of Miami
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629489406
- **Authorized official:** DR. GALEN GRAYSON M.D. (MEDICAL DIRECTOR/OWNER)
- **Authorized official phone:** (877) 881-0022

## Contact information

- **Practice address:** 1661 SW 37TH AVE, STE. 102, MIAMI, FL 33145-1754
- **Practice address phone:** (305) 461-2400
- **Practice address fax:** (305) 461-2902
- **Mailing address:** 1661 SW 37TH AVE, STE. 102, MIAMI, FL 33145-1754
- **Mailing address phone:** (305) 461-2400
- **Mailing address fax:** (305) 461-2902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2014
- **Last updated:** 05/14/2014