Provider Demographics
NPI:1174057301
Name:VISION CARE GROUP
Entity type:Organization
Organization Name:VISION CARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-401-2163
Mailing Address - Street 1:250 CATALONIA AVE
Mailing Address - Street 2:STE 302
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6735
Mailing Address - Country:US
Mailing Address - Phone:305-401-2163
Mailing Address - Fax:
Practice Address - Street 1:250 CATALONIA AVE
Practice Address - Street 2:STE 304
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6735
Practice Address - Country:US
Practice Address - Phone:305-401-2163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management