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General NPI Number Information
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NPI Number | 1386913358
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Entity Type | Organization
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Legal Business Name | INVISION HEALTHCARE LLC
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 118 DATE PALM DR
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City | JUPITER
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State | FL
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Zip | 33458-2802
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Country | US
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Telephone | 561-707-8927
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Fax |
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Provider Business Mailing Address
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Address Line | 118 DATE PALM DR
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City | JUPITER
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State | FL
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Zip | 33458-2802
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Country | US
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Telephone | 561-707-8927
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. RANDY G NOAKES
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Credential | RN, BSN
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Telephone | 561-707-8927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | L11000093308
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License Number State | FL
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