Provider Demographics
NPI:1891850590
Name:VISIONCARE UNLIMITED, INC.
Entity Type:Organization
Organization Name:VISIONCARE UNLIMITED, INC.
Other - Org Name:VISIONCARE UNLIMITED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIENNE
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:ROSENBUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-241-5665
Mailing Address - Street 1:2901 CLINT MOORE RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2041
Mailing Address - Country:US
Mailing Address - Phone:561-241-5665
Mailing Address - Fax:561-241-5489
Practice Address - Street 1:2901 CLINT MOORE RD
Practice Address - Street 2:SUITE 8
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2041
Practice Address - Country:US
Practice Address - Phone:561-241-5665
Practice Address - Fax:561-241-5489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-25
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2721152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0898960001Medicare NSC
FL20456Medicare PIN