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General NPI Number Information
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NPI Number | 1043415433
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Entity Type | Organization
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Legal Business Name | INVISION WORKS LLC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3195 CITRUS TOWER BLVD
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City | CLERMONT
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State | FL
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Zip | 34711
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Country | US
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Telephone | 352-241-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 3195 CITRUS TOWER BLVD
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City | CLERMONT
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State | FL
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Zip | 34711
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Country | US
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Telephone | 352-241-9700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE K FLUD
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Credential | DO
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Telephone | 352-241-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | OS9523
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License Number State | FL
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