Provider Demographics
NPI:1114167632
Name:VITRECTOMY RECOVERY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:VITRECTOMY RECOVERY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MORETTI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:407-656-8892
Mailing Address - Street 1:PO BOX 784326
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34778-4326
Mailing Address - Country:US
Mailing Address - Phone:407-656-8892
Mailing Address - Fax:407-656-8892
Practice Address - Street 1:15227 STARLEIGH RD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4698
Practice Address - Country:US
Practice Address - Phone:407-656-8892
Practice Address - Fax:407-656-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment