Provider Demographics
NPI:1043415433
Name:INVISION WORKS LLC
Entity Type:Organization
Organization Name:INVISION WORKS LLC
Other - Org Name:PREMIER OPTHALMOLOGY & AESTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FLUD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-241-9700
Mailing Address - Street 1:3195 CITRUS TOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711
Mailing Address - Country:US
Mailing Address - Phone:352-241-9700
Mailing Address - Fax:
Practice Address - Street 1:3195 CITRUS TOWER BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711
Practice Address - Country:US
Practice Address - Phone:352-241-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9523261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI35408Medicare UPIN
LAU5033ZMedicare ID - Type UnspecifiedMEDICARE