Provider Demographics
NPI:1639356520
Name:VISION-QUEST, INC.
Entity Type:Organization
Organization Name:VISION-QUEST, INC.
Other - Org Name:DOWNTOWN OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:GRACZYK
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:954-764-6962
Mailing Address - Street 1:800 E BROWARD BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2008
Mailing Address - Country:US
Mailing Address - Phone:954-764-6962
Mailing Address - Fax:954-524-9400
Practice Address - Street 1:800 E BROWARD BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2008
Practice Address - Country:US
Practice Address - Phone:954-764-6962
Practice Address - Fax:954-524-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO1726332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112310OtherEYEMED
FL0756930001Medicare NSC