Healthcare Provider Details

I. General information

NPI: 1245626027
Provider Name (Legal Business Name): FLORIDA VISION CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 06/14/2025
Certification Date: 06/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28901 TRAILS EDGE BLVD STE 201
BONITA SPRINGS FL
34134-7588
US

IV. Provider business mailing address

2338 IMMOKALEE RD # 203
NAPLES FL
34110-1445
US

V. Phone/Fax

Practice location:
  • Phone: 239-919-4342
  • Fax: 239-919-4342
Mailing address:
  • Phone: 239-919-4342
  • Fax: 239-919-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME103168
License Number StateFL

VIII. Authorized Official

Name: DR. BORIS OVODENKO
Title or Position: PRESIDENT
Credential: MD
Phone: 646-236-8702