Organization Active NPI

Vista Vision Eyecare LLC

  • Optometrist
  • Fort Myers, FL
National Provider Identifier
1841415817
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3580 Issued in FL
Legal business name
VISTA VISION EYECARE LLC
Practice address
5170 S Cleveland Ave
Fort Myers, FL 33907-2142
Phone
(305) 804-0476
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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, OD
Title
Optometrist
Phone
(305) 804-0476

Specialties & licenses 1

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

Addresses

Primary practice location

5170 S Cleveland Ave
Fort Myers, FL 33907-2142

Mailing address

13625 Eagle Ridge Dr
Apt 334
Fort Myers, FL 33912-7824
Phone (305) 804-0476

Other identifiers 1

IdentifierTypeStateIssuer
1407956048OtherFLNPI

National Provider Directory

National Provider Directory

Locations

13641 SW 26th St
Miami, FL 33175
Phone (305) 559-1314

Practitioners & affiliated clinicians

Practitioners 3

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1841415817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13625 EAGLE RIDGE DR",
            "address_2": "APT 334",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127824",
            "telephone_number": "305-804-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 S CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072142",
            "telephone_number": "305-804-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA VISION EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-09-10",
        "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 Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.