MEDICARE: ENVISION HEALTH

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	261QI0500X	Infusion Therapy Clinic/Center

General Provider Information

NPI Number	:	1932770088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENVISION HEALTH

Provider Business Mailing Address
First Line	:	4427 SAXON DR
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32169-4136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4427 SAXON DR
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32169-4136
Country	:	US
Telephone Number	:	973-202-4369
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL BILLER
Name	:	MRS. LOLITA ECHEVARRIA
Credential	:
Telephone Number	:	862-686-7977

Provider Enumeration Date	:	07/08/2021
Last Update Date	:	07/11/2021

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