Provider Demographics
NPI:1295843993
Name:VISUAL HEALTH & SURGICAL CENTER
Entity Type:Organization
Organization Name:VISUAL HEALTH & SURGICAL CENTER
Other - Org Name:CITY LASER & OPTIQUE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:STATEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-964-0707
Mailing Address - Street 1:2889 10TH AVENUE NORTH
Mailing Address - Street 2:STE 305
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461
Mailing Address - Country:US
Mailing Address - Phone:561-964-0707
Mailing Address - Fax:561-964-8164
Practice Address - Street 1:701 ROSEMARY AVENUE
Practice Address - Street 2:#103
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-659-2299
Practice Address - Fax:561-964-8164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty