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General NPI Number Information
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NPI Number | 1992953228
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Entity Type | Organization
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Legal Business Name | VISION DEVELOPMENT CENTER, INC.
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 05/09/2015
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Provider Practice Location Address
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Address Line | 319 BELVEDERE RD SUITE 1
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-1252
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Country | US
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Telephone | 561-296-3865
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Fax | 561-624-8924
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Provider Business Mailing Address
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Address Line | 319 BELVEDERE RD SUITE 1
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-1252
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Country | US
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Telephone | 561-296-3865
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Fax | 561-624-8924
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. REGINA LOUISE MANES
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Credential | O.D., M.S.
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Telephone | 561-296-3865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | OPC2192
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License Number State | FL
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