Provider Demographics
NPI:1629442975
Name:VIVO VISION INC.
Entity Type:Organization
Organization Name:VIVO VISION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:NADINE
Authorized Official - Last Name:PINON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-351-8858
Mailing Address - Street 1:7500 W LAKE MEAD BLVD
Mailing Address - Street 2:#465
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0297
Mailing Address - Country:US
Mailing Address - Phone:702-351-8858
Mailing Address - Fax:
Practice Address - Street 1:4355 S GRAND CANYON DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7106
Practice Address - Country:US
Practice Address - Phone:702-351-8858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV692152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty