MEDICARE: INFINITY VISION 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	156FX1800X	Optician	DO 4712	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265544621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITY VISION INC

Provider Business Mailing Address
First Line	:	4500 NW 183RD ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-3045
Country	:	US
Telephone Number	:	305-620-3901
Fax Number	:	305-620-3940

Provider Business Practice Location Address
First Line	:	4500 NW 183RD ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-3045
Country	:	US
Telephone Number	:	305-620-3901
Fax Number	:	305-620-3940

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MANUEL F PEREZ
Credential	:
Telephone Number	:	305-620-3901

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	04/14/2015

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Directions to “INFINITY VISION INC ” Practice Location

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