Provider Demographics
NPI:1114579232
Name:DIGIVISION CARE, LLC
Entity Type:Organization
Organization Name:DIGIVISION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED OPTICAL LEAD
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DO5482
Authorized Official - Phone:321-972-1823
Mailing Address - Street 1:2600 MAITLAND CENTER PKWY STE 162
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4162
Mailing Address - Country:US
Mailing Address - Phone:321-972-1823
Mailing Address - Fax:
Practice Address - Street 1:2600 MAITLAND CENTER PKWY STE 162
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4162
Practice Address - Country:US
Practice Address - Phone:321-972-1823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty