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General NPI Number Information
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NPI Number | 1134617004
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Entity Type | Organization
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Legal Business Name | VISION SCIENTIFIC LLC
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 2286 N US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34946
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Country | US
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Telephone | 772-444-0505
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Fax | 772-324-6325
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Provider Business Mailing Address
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Address Line | 2286 N US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34946-8914
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Country | US
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Telephone | 772-444-0505
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Fax | 772-324-6325
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATION
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Name | MRS. STACY CALLEAN MCKENZIE
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Credential |
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Telephone | 772-380-5742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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