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General NPI Number Information
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NPI Number | 1215487913
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Entity Type | Organization
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Legal Business Name | ENVISION EYEWEAR, LLC
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 60 SW 17TH ST
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City | OCALA
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State | FL
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Zip | 34471-8142
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Country | US
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Telephone | 352-482-0305
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3979
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City | SARASOTA
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State | FL
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Zip | 34230-3979
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Country | US
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Telephone | 352-482-0305
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Fax | 352-482-0311
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | REGINA I WEBB
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Credential |
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Telephone | 352-795-6080
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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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