Provider Demographics
NPI:1245541036
Name:ADVANTAGE VISION CARE
Entity type:Organization
Organization Name:ADVANTAGE VISION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AFROUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTEDAEINY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-510-4777
Mailing Address - Street 1:11312 WILES RD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2113
Mailing Address - Country:US
Mailing Address - Phone:954-510-4777
Mailing Address - Fax:954-510-8777
Practice Address - Street 1:11312 WILES RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-2113
Practice Address - Country:US
Practice Address - Phone:954-510-4777
Practice Address - Fax:954-510-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty