# VISUAL HEALTH AT JUPITER EYE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013027317
- **Authorized official:** MADONNA COFFMAN (ADMINISTARTOR)
- **Authorized official phone:** (561) 227-3101

## Contact information

- **Practice address:** 102 COASTAL WAY, \#103, JUPITER, FL 33477-5004
- **Practice address phone:** (561) 747-1111
- **Practice address fax:** (561) 744-6682
- **Mailing address:** 2889 10TH AVE N, STE 305, LAKE WORTH, FL 33461-3045
- **Mailing address phone:** (561) 964-0707
- **Mailing address fax:** (561) 227-3183

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 04/09/2010