MEDICARE: PERFECT VISION OPTICAL LLC

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	163W00000X	Registered Nurse

General Provider Information

NPI Number	:	1326826173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFECT VISION OPTICAL LLC

Provider Business Mailing Address
First Line	:	1834 W 72ND PL
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-3709
Country	:	US
Telephone Number	:	786-266-8353
Fax Number	:

Provider Business Practice Location Address
First Line	:	5370 PALM AVE STE 2
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2766
Country	:	US
Telephone Number	:	305-820-9771
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JULIO M IGLESIAS
Credential	:	APRN
Telephone Number	:	786-266-8353

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	09/21/2023

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Directions to “PERFECT VISION OPTICAL LLC ” Practice Location

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