MEDICARE: RADIANT VISION EYECARE

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1568170827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIANT VISION EYECARE

Provider Business Mailing Address
First Line	:	1500 BEVILLE RD
Second Line	:	SUITE 606, MAILBOX 369
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5517 S WILLIAMSON BLVD STE 310
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-8310
Country	:	US
Telephone Number	:	386-200-4501
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARISSA NICOTRA
Credential	:	O.D.
Telephone Number	:	386-200-4501

Provider Enumeration Date	:	11/07/2022
Last Update Date	:	11/07/2022

Similar Medicare Providers

1174798433 — ORANGE COUNTY NEWBORN MEDICARE CARE PC
Practice Location Address:

3 SAINT STEPHENS PL , SUITE 2
WARWICK, NY
10990-3208

Practice Phone: 845-987-9700
Practice Fax:

1801173091 — VISIONWORKS, INC.
Practice Location Address:

5517 S WILLIAMSON BLVD , SUITE 310
PORT ORANGE, FL
32128-8310

Practice Phone: 386-322-4304
Practice Fax: 386-788-4932

1295461879 — DR. MARISSA NICOTRA-BARNES OD
Practice Location Address:

5517 S WILLIAMSON BLVD STE 310
PORT ORANGE, FL
32128-8310

Practice Phone: 386-322-4304
Practice Fax:

1144095605 — 100 CHIRO ROSADO PT ORANGE PLLC
Practice Location Address:

5517 S WILLIAMSON BLVD STE 305
PORT ORANGE, FL
32128-8310

Practice Phone: 386-444-7700
Practice Fax: 386-444-7070

1205709896 — BEACON CHIRO AND WELLNESS PLLC
Practice Location Address:

5517 S WILLIAMSON BLVD STE 305
PORT ORANGE, FL
32128-8310

Practice Phone: 386-444-7700
Practice Fax: 386-444-7070

1285011429 — RATHER BE HOME, LLC
Practice Location Address:

8310 PORT JACKSON AVE NW , SUITE 302
NORTH CANTON, OH
44720-5463

Practice Phone: 330-526-0483
Practice Fax:

Directions to “RADIANT VISION EYECARE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.