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General NPI Number Information
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NPI Number | 1679882435
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Entity Type | Organization
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Legal Business Name | ALAFAYA VISION CENTER, LLC
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 891 N ALAFAYA TRL #G05
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City | ORLANDO
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State | FL
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Zip | 32828-7049
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Country | US
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Telephone | 407-382-2648
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Fax | 407-382-8785
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Provider Business Mailing Address
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Address Line | 891 N ALAFAYA TRL #G05
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City | ORLANDO
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State | FL
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Zip | 32828-7049
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Country | US
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Telephone | 407-382-2648
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Fax | 407-382-8785
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Authorized Official
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Title or Position | OWNER
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Name | MS. NAILA VIRANI
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Credential | O.D.
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Telephone | 407-382-2648
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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 | OPC4492
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License Number State | FL
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