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General NPI Number Information
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NPI Number | 1114579232
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Entity Type | Organization
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Legal Business Name | DIGIVISION CARE, LLC
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 07/09/2019
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Provider Practice Location Address
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Address Line | 2600 MAITLAND CENTER PKWY STE 162
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City | MAITLAND
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State | FL
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Zip | 32751-4162
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Country | US
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Telephone | 321-972-1823
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 MAITLAND CENTER PKWY STE 162
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City | MAITLAND
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State | FL
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Zip | 32751-4162
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Country | US
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Telephone | 321-972-1823
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Fax |
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Authorized Official
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Title or Position | LICENSED OPTICAL LEAD
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Name | MISS ANNA MARIE COX
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Credential | DO5482
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Telephone | 321-972-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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