# ADVANCED EYE CARE MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Envision Eye & Laser Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124460621
- **Authorized official:** RENEE C BOVELLE MD (OWNER)
- **Authorized official phone:** (301) 805-4664

## Contact information

- **Practice address:** 12200 ANNAPOLIS RD, SUITE 116, GLENN DALE, MD 20769-9182
- **Practice address phone:** (301) 805-4664
- **Mailing address:** 12200 ANNAPOLIS RD, SUITE 116, GLENN DALE, MD 20769-9182
- **Mailing address phone:** (301) 805-4664

## Taxonomy

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

## Other

- **Enumeration date:** 07/24/2013
- **Last updated:** 03/23/2016