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General NPI Number Information
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NPI Number | 1407321318
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Entity Type | Organization
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Legal Business Name | REAL VISION CENTER, INC.
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Dates
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Enumeration Date | 10/06/2018
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Last Update Date | 10/06/2018
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Provider Practice Location Address
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Address Line | 14934 PINES BLVD STE 125
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1213
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Country | US
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Telephone | 954-367-3633
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Fax | 954-367-6313
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Provider Business Mailing Address
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Address Line | 7965 SHALIMAR ST
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City | MIRAMAR
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State | FL
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Zip | 33023-2429
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Country | US
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Telephone | 786-281-7285
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. MAGDALENA SAINT-LOUIS
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Credential | OD
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Telephone | 786-281-7285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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