MEDICARE: VIVO 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	152W00000X	Optometrist	692	NV

General Provider Information

NPI Number	:	1629442975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIVO VISION INC.

Provider Business Mailing Address
First Line	:	7500 W LAKE MEAD BLVD
Second Line	:	#465
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0297
Country	:	US
Telephone Number	:	702-351-8858
Fax Number	:

Provider Business Practice Location Address
First Line	:	4355 S GRAND CANYON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7106
Country	:	US
Telephone Number	:	702-351-8858
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MONICA NADINE PINON
Credential	:	OD
Telephone Number	:	702-351-8858

Provider Enumeration Date	:	11/24/2015
Last Update Date	:	11/24/2015

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Directions to “VIVO VISION INC. ” Practice Location

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