MEDICARE: VISOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1215888003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISOLOGY INC

Provider Business Mailing Address
First Line	:	20815 NE 16TH AVE STE B15
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-2121
Country	:	US
Telephone Number	:	305-541-7999
Fax Number	:

Provider Business Practice Location Address
First Line	:	779 MCGRATH HWY
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02145-2122
Country	:	US
Telephone Number	:	305-541-7999
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MOISES FRIDZON
Credential	:
Telephone Number	:	305-541-7999

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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Directions to “VISOLOGY INC ” Practice Location

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