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Organization
BUENA VISTA VISION CLUB, INC
Active
Organization
BUENA VISTA VISION CLUB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIETA DIAZ PADRON OD (OWNER)
(305) 713-8170
Entity
Organization
Contact information
Practice address
13780 SW 26TH ST STE 201, MIAMI, FL 33175-6302
(305) 439-2015
(305) 675-0443
Mailing address
16328 SW 43RD TER, MIAMI, FL 33185-5328
(305) 713-8170
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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