Provider Demographics
NPI:1568120277
Name:LIGHT OF VISION CARE SERVICE LOV LLC
Entity Type:Organization
Organization Name:LIGHT OF VISION CARE SERVICE LOV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-317-0668
Mailing Address - Street 1:PO BOX 1011
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-1011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6207 COLMAR PL
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-1617
Practice Address - Country:US
Practice Address - Phone:813-317-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No251J00000XAgenciesNursing Care
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBusGroup - Single Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty
No376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, ChildGroup - Single Specialty