Healthcare Provider Details

I. General information

NPI: 1740191329
Provider Name (Legal Business Name): FAMILY VISION GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17560 NW 27TH AVE STE 119
MIAMI GARDENS FL
33056-4075
US

IV. Provider business mailing address

17560 NW 27TH AVE STE 119
MIAMI GARDENS FL
33056-4075
US

V. Phone/Fax

Practice location:
  • Phone: 305-974-2048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: REYNALDP JESUS HERNANDEZ LIMA
Title or Position: OWNER
Credential: DO
Phone: 786-560-3766