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General NPI Number Information
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NPI Number | 1760982656
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Entity Type | Organization
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Legal Business Name | FLORIDA VISION INSTITUTE, INC.
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 10050 SW INNOVATION WAY STE 101
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-2117
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Country | US
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Telephone | 772-345-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 SE MONTEREY RD STE 104
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City | STUART
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State | FL
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Zip | 34994-4512
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Country | US
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Telephone | 772-283-2020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE L NEAL
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Credential |
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Telephone | 469-214-0144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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