Provider Demographics
NPI:1154561546
Name:ENVISION EYE SPECIALISTS, LLC
Entity type:Organization
Organization Name:ENVISION EYE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-338-7773
Mailing Address - Street 1:3200 SW 34TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7408
Mailing Address - Country:US
Mailing Address - Phone:216-338-7773
Mailing Address - Fax:352-482-0311
Practice Address - Street 1:3200 SW 34TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7408
Practice Address - Country:US
Practice Address - Phone:216-338-7773
Practice Address - Fax:352-482-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty