Provider Demographics
NPI:1003902628
Name:QUANTUM VISION CARE LLC
Entity Type:Organization
Organization Name:QUANTUM VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALDES-LORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-649-4900
Mailing Address - Street 1:2945 SW 8 STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2826
Mailing Address - Country:US
Mailing Address - Phone:305-649-4900
Mailing Address - Fax:305-649-2352
Practice Address - Street 1:1332 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2320
Practice Address - Country:US
Practice Address - Phone:305-649-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL39659207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty