Healthcare Provider Details
I. General information
NPI: 1134728561
Provider Name (Legal Business Name): INVISION HEALTH FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2020
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1620 SOUTHERN BLVD
WEST PALM BEACH FL
33406-3242
US
IV. Provider business mailing address
400 INTERNATIONAL DRIVE
WILLIAMSVILLE NY
14221-5771
US
V. Phone/Fax
- Phone: 561-800-4111
- Fax: 716-631-9525
- Phone: 716-631-3555
- Fax: 716-631-9525
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MICHAEL
K
LANDI
Title or Position: PRESIDENT/COO
Credential: MD
Phone: 716-631-3555