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General NPI Number Information
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NPI Number | 1912213315
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Entity Type | Organization
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Legal Business Name | ESPIALLT VISION NETWORK PLLC
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 1321 NW 14TH ST SUTIE 603
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City | MIAMI
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State | FL
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Zip | 33125-1673
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Country | US
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Telephone | 305-545-9393
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Fax | 305-547-2393
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Provider Business Mailing Address
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Address Line | 1321 NW 14TH ST SUTIE 603
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City | MIAMI
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State | FL
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Zip | 33125-1673
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Country | US
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Telephone | 305-545-9393
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Fax | 305-547-2393
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEJANDRO ESPAILLAT
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Credential | MD
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Telephone | 305-545-9393
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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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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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