Healthcare Provider Details
I. General information
NPI: 1871430710
Provider Name (Legal Business Name): VISION AND MISSION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8455 N WICKHAM RD
MELBOURNE FL
32940-6607
US
IV. Provider business mailing address
177 EASTON CIR
OVIEDO FL
32765-8479
US
V. Phone/Fax
- Phone: 909-936-4251
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONICA
MIKHAIL
Title or Position: OPTOMETRIST
Credential: OD
Phone: 909-936-4251