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General NPI Number Information
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NPI Number | 1093522260
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Entity Type | Organization
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Legal Business Name | VITREO 3 INVESTMENT GROUP LLC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 8001 S ORANGE BLOSSOM TRL UNIT 1560
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City | ORLANDO
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State | FL
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Zip | 32809-7654
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Country | US
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Telephone | 321-443-9616
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Fax |
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Provider Business Mailing Address
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Address Line | 2699 SUNKISSED DR
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City | SAINT CLOUD
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State | FL
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Zip | 34771-8489
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AMBAR RODRIGUEZ
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Credential |
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Telephone | 321-443-9616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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