Vip Univida Optical, Inc. | |
101 Nw 57th Ave Miami FL 33126-4804 | |
(305) 239-2515 | |
Not Available |
Full Name | Vip Univida Optical, Inc. |
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Speciality | Clinic/Center |
Location | 101 Nw 57th Ave, Miami, Florida |
Authorized Official Name and Position | Yisell Alfonso (OWNER) |
Authorized Official Contact | 7863390099 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vip Univida Optical, Inc. 101 Nw 57th Ave Miami FL 33126-4804 Ph: (305) 239-2515 | Vip Univida Optical, Inc. 101 Nw 57th Ave Miami FL 33126-4804 Ph: (305) 239-2515 |
NPI Number | 1265187132 |
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Provider Enumeration Date | 02/18/2022 |
Last Update Date | 07/30/2024 |
Medicare PECOS PAC ID | 1658742234 |
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Medicare Enrollment ID | O20230118001015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265187132 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Javier Archilla |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235552142 PECOS PAC ID: 4385865765 Enrollment ID: I20141028002737 |
Provider Name | Thailiz Vazquez Cedeno |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1912696535 PECOS PAC ID: 2163884503 Enrollment ID: I20230816002290 |
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