Envision Life Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ENVISION LIFE MEDICAL LLC

Practice address

101 N US Highway 1 Ste 207
Fort Pierce, FL 34950-4256

Phone

(772) 228-1190

Fax

(855) 205-6117

NPI assigned

Mar 6, 2019

Organization subpart

No

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

Authorized official

Name

Omar Fermin

Title

Owner

Phone

(772) 228-1190

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1992263107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N US HIGHWAY 1 STE 207",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504256",
            "telephone_number": "772-228-1190",
            "fax_number": "855-205-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N US HIGHWAY 1 STE 207",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504256",
            "telephone_number": "772-228-1190",
            "fax_number": "855-205-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION LIFE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "FERMIN",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-228-1190"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.