Provider Demographics
NPI:1265291140
Name:VISION FIRST FLORIDA LLC
Entity type:Organization
Organization Name:VISION FIRST FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:863-398-2455
Mailing Address - Street 1:6595 S FLORIDA AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6595 S FLORIDA AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3316
Practice Address - Country:US
Practice Address - Phone:863-398-2454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty