Provider Demographics
NPI:1093735300
Name:VISIONS HEALTHCARE - EL PORTAL INC
Entity Type:Organization
Organization Name:VISIONS HEALTHCARE - EL PORTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MALCOM
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-751-7301
Mailing Address - Street 1:8642 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:EL PORTAL
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3004
Mailing Address - Country:US
Mailing Address - Phone:305-751-7301
Mailing Address - Fax:
Practice Address - Street 1:8642 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:EL PORTAL
Practice Address - State:FL
Practice Address - Zip Code:33138-3004
Practice Address - Country:US
Practice Address - Phone:305-751-7301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty