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Organization
VISTA VISION EYECARE LLC
Active
Organization
VISTA VISION EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL ENRIQUE DE LA TORRE OD (OPTOMETRIST)
(305) 804-0476
Entity
Organization
Contact information
Practice address
5170 S CLEVELAND AVE, FORT MYERS, FL 33907-2142
(305) 804-0476
Mailing address
13625 EAGLE RIDGE DR, APT 334, FORT MYERS, FL 33912-7824
(305) 804-0476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3580
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407956048
NPI
FL
Enumeration date
04/16/2007
Last updated
09/10/2009
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