Provider Demographics
NPI:1043429764
Name:BELL VISION CENTER, INC.
Entity Type:Organization
Organization Name:BELL VISION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:EMILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-981-4775
Mailing Address - Street 1:14030 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-3443
Mailing Address - Country:US
Mailing Address - Phone:305-981-4775
Mailing Address - Fax:
Practice Address - Street 1:14030 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-3443
Practice Address - Country:US
Practice Address - Phone:305-981-4775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO0004560156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL630307200Medicaid