Healthcare Provider Details

I. General information

NPI: 1730372640
Provider Name (Legal Business Name): AMERICAN NEW VISION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 W SUNRISE BLVD
PLANTATION FL
33313-6037
US

IV. Provider business mailing address

6500 W SUNRISE BLVD
PLANTATION FL
33313-6037
US

V. Phone/Fax

Practice location:
  • Phone: 954-324-8920
  • Fax: 954-414-4319
Mailing address:
  • Phone: 954-324-8920
  • Fax: 954-414-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: MR. TONY OUSTABASSIDIS
Title or Position: OWNER
Credential:
Phone: 954-864-3996