Provider Demographics
NPI:1144704404
Name:MED VISION ASSOC INC
Entity type:Organization
Organization Name:MED VISION ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIADNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-898-3226
Mailing Address - Street 1:9600 SW 8TH ST STE 16
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2947
Mailing Address - Country:US
Mailing Address - Phone:786-773-2424
Mailing Address - Fax:954-653-1450
Practice Address - Street 1:9600 SW 8TH ST STE 16
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2947
Practice Address - Country:US
Practice Address - Phone:786-773-2424
Practice Address - Fax:954-653-1450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000395200Medicaid