Provider Demographics
NPI:1336294347
Name:LKS HOLDINGS, INC.
Entity Type:Organization
Organization Name:LKS HOLDINGS, INC.
Other - Org Name:VISIONPLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:772-770-2020
Mailing Address - Street 1:792 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-4701
Mailing Address - Country:US
Mailing Address - Phone:772-770-2020
Mailing Address - Fax:772-770-4617
Practice Address - Street 1:792 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32962-4701
Practice Address - Country:US
Practice Address - Phone:772-770-2020
Practice Address - Fax:772-770-4617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOE880332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3996970001Medicare NSC