Provider Demographics
NPI:1720733835
Name:VIZIO EYE CARE LLC
Entity Type:Organization
Organization Name:VIZIO EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM-OANH
Authorized Official - Middle Name:NU
Authorized Official - Last Name:TON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-261-6769
Mailing Address - Street 1:7808 NW 71ST WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2207
Mailing Address - Country:US
Mailing Address - Phone:954-560-1042
Mailing Address - Fax:
Practice Address - Street 1:9129 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6951
Practice Address - Country:US
Practice Address - Phone:954-282-1101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty