MEDICARE: VISION MAGIC

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	DO2818	FL

General Provider Information

NPI Number	:	1336306646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION MAGIC

Provider Business Mailing Address
First Line	:	1369 BEVILLE RD
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32119-1529
Country	:	US
Telephone Number	:	386-767-2020
Fax Number	:	386-761-8210

Provider Business Practice Location Address
First Line	:	1369 BEVILLE RD
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32119-1529
Country	:	US
Telephone Number	:	386-767-2020
Fax Number	:	386-761-8210

Authorized Official
Title or Position	:	OWNER
Name	:	MR. HARRY ROWLEY
Credential	:	D.O.
Telephone Number	:	386-767-2020

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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Directions to “VISION MAGIC ” Practice Location

Language	Start Address	Practice Location

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