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General NPI Number Information
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NPI Number | 1316170202
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Entity Type | Organization
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Legal Business Name | VISION QUEST OPHTHALMOLOGY, LLC
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 8130 ROYAL PALM BLVD SUITE 205
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5703
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Country | US
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Telephone | 708-822-1987
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Fax | 954-753-8309
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Provider Business Mailing Address
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Address Line | PO BOX 9834
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City | CORAL SPRINGS
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State | FL
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Zip | 33075-0834
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Country | US
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Telephone | 708-822-1987
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Fax | 954-753-8309
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. CINDY MARIA HERNANDEZ
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Credential | D.O.
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Telephone | 708-822-1987
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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 | OS 10559
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License Number State | FL
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