Healthcare Provider Details

I. General information

NPI: 1467579169
Provider Name (Legal Business Name): VISION REHABILITATION ASSOCIATES, P.L.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6618 W ATLANTIC AVE
DELRAY BEACH FL
33446-1616
US

IV. Provider business mailing address

PO BOX 970543
BOCA RATON FL
33497-0543
US

V. Phone/Fax

Practice location:
  • Phone: 561-498-5007
  • Fax:
Mailing address:
  • Phone: 561-271-4962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. LAURA MARIE DEMARCO
Title or Position: OWNER, OPTOMETRIST
Credential: O.D.
Phone: 561-271-4962