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
—
—
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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