Provider Demographics
NPI:1679013932
Name:OPTOMETRY VISION CARE PLLC
Entity Type:Organization
Organization Name:OPTOMETRY VISION CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOROBEVA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-477-8469
Mailing Address - Street 1:11180 TURNBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-2336
Mailing Address - Country:US
Mailing Address - Phone:904-477-8469
Mailing Address - Fax:
Practice Address - Street 1:14866 OLD ST. AUGUSTINE RD UNIT 110
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258
Practice Address - Country:US
Practice Address - Phone:904-477-8469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4592152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty