Provider Demographics
NPI:1386913358
Name:INVISION HEALTHCARE LLC
Entity type:Organization
Organization Name:INVISION HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:G
Authorized Official - Last Name:NOAKES
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:561-707-8927
Mailing Address - Street 1:118 DATE PALM DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2802
Mailing Address - Country:US
Mailing Address - Phone:561-707-8927
Mailing Address - Fax:
Practice Address - Street 1:118 DATE PALM DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2802
Practice Address - Country:US
Practice Address - Phone:561-707-8927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL11000093308293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory