Provider Demographics
NPI:1750734364
Name:HD VISION CENTER
Entity type:Organization
Organization Name:HD VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:JULIA
Authorized Official - Last Name:HEVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-400-1517
Mailing Address - Street 1:10938 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-1706
Mailing Address - Country:US
Mailing Address - Phone:754-400-1517
Mailing Address - Fax:
Practice Address - Street 1:10938 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-1706
Practice Address - Country:US
Practice Address - Phone:754-400-1517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO6726156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty