=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427752823
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VISION ASSIST LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2023
-----------------------------------------------------
Last Update Date | 03/29/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 113 N PALAFOX ST
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32502-4838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-377-5007
-----------------------------------------------------
Fax | 850-204-4257
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 113 N PALAFOX ST
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32502-4838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-377-5007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING MANAGER
-----------------------------------------------------
Name | LAURA HANES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 850-377-5007
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------