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General NPI Number Information
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NPI Number | 1962351890
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Entity Type | Organization
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Legal Business Name | VISION VA OPTICAL LLC
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 2653 NW 79TH AVE
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City | DORAL
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State | FL
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Zip | 33122-1036
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Country | US
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Telephone | 786-447-1044
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Fax |
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Provider Business Mailing Address
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Address Line | 1622 SW 139TH AVE
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City | MIAMI
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State | FL
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Zip | 33175-7501
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Country | US
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Telephone | 786-447-1044
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. THAILIZ VAZQUEZ CEDENO
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Credential | OD
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Telephone | 786-447-1044
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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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