Organization Active NPI

Vista Vision Eyecare 2, Inc.

  • Optometrist
  • Ft. Myers, FL
National Provider Identifier
1609092337
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3580 Issued in FL
Legal business name
VISTA VISION EYECARE 2, INC.
Practice address
9918 Gulf Coast Main
Suite B100
Ft. Myers, FL 33913
Phone
(239) 482-6745
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Miguel Enrique De la Torre, ODNPI 1407956048
Title
Optometrist
Phone
(305) 804-0476

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC3580 FL Primary

Addresses

Primary practice location

9918 Gulf Coast Main
Suite B100
Ft. Myers, FL 33913

Mailing address

13625 Eagle Ridge Dr Apt 334
Fort Myers, FL 33912-1882
Phone (305) 804-0476

Other identifiers 1

IdentifierTypeStateIssuer
1407956048OtherFLNPI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609092337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13625 EAGLE RIDGE DR APT 334",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121882",
            "telephone_number": "305-804-0476",
            "fax_number": "239-265-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9918 GULF COAST MAIN",
            "address_2": "SUITE B100",
            "city": "FT. MYERS",
            "state": "FL",
            "postal_code": "33913",
            "telephone_number": "239-482-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA VISION EYECARE 2, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DE LA TORRE",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ENRIQUE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "305-804-0476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407956048",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.