Provider Demographics
NPI:1619647724
Name:PINNACLE VISION CARE, INC
Entity Type:Organization
Organization Name:PINNACLE VISION CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOULDS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:863-658-0645
Mailing Address - Street 1:919 MALL RING RD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-8515
Mailing Address - Country:US
Mailing Address - Phone:863-658-0645
Mailing Address - Fax:863-658-0646
Practice Address - Street 1:919 MALL RING RD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-8515
Practice Address - Country:US
Practice Address - Phone:863-658-0645
Practice Address - Fax:863-658-0646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty