Provider Demographics
NPI:1013772086
Name:CHOICE VISION CARE & WELLNESS INC
Entity type:Organization
Organization Name:CHOICE VISION CARE & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:F
Authorized Official - Last Name:DECANIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-665-0437
Mailing Address - Street 1:628 CYPRESS KEY CIR
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1234
Mailing Address - Country:US
Mailing Address - Phone:561-665-0437
Mailing Address - Fax:561-516-6999
Practice Address - Street 1:8475 LAKE WORTH RD STE 200
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2427
Practice Address - Country:US
Practice Address - Phone:800-520-4675
Practice Address - Fax:561-516-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty