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NPI Code Detail

MEDICARE: SAND VISION LLC

MEDICARE: SAND VISION LLC
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1437636396
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAND VISION LLC
Provider Business Mailing Address
First Line : 3000 OASIS GRAND BLVD APT 3107
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-1646
Country : US
Telephone Number : 314-973-3213
Fax Number :
Provider Business Practice Location Address
First Line : 6891 DANIELS PKWY STE 140
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-1503
Country : US
Telephone Number : 314-973-3213
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. SUSAN ERKER
Credential :
Telephone Number : 314-973-3213
Provider Enumeration Date : 07/24/2018
Last Update Date : 07/24/2018

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Directions to “SAND VISION LLC ” Practice Location

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