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General NPI Number Information
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NPI Number | 1083468946
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Entity Type | Organization
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Legal Business Name | VISOLOGY INC
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Dates
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Enumeration Date | 04/16/2024
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 2991 CRANBERRY HWY
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City | EAST WAREHAM
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State | MA
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Zip | 02538-1354
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Country | US
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Telephone | 305-541-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 20815 NE 16TH AVE
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City | MIAMI
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State | FL
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Zip | 33179-2138
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Country | US
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Telephone | 305-541-7999
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MOISES FRIDZON
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Credential |
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Telephone | 305-541-7999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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