Healthcare Provider Details

I. General information

NPI: 1316422595
Provider Name (Legal Business Name): CASE VISION, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2564 ENTERPRISE RD
ORANGE CITY FL
32763-7904
US

IV. Provider business mailing address

2564 ENTERPRISE RD
ORANGE CITY FL
32763-7904
US

V. Phone/Fax

Practice location:
  • Phone: 386-774-7242
  • Fax: 386-774-8442
Mailing address:
  • Phone: 386-774-7242
  • Fax: 386-774-8442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JOHN MICHAEL CASE
Title or Position: OWNER
Credential: O.D.
Phone: 386-316-4160