| Organization Name: | AQUA VISION CARE, LLC |
| NPI Number: | 1093057226 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELECHI MEZU (DIRECTOR) |
| Mailing Address: | 1006 Reisterstown Rd Pikesville |
| State: | MD US |
| Postal Code: | 212084206 |
| Phone Number: | 4106021567 |
| Fax Number: | 4106021568 |
| NPI Enumeration Date: | 03/26/2013 |
| NPI Last Update Date: | 03/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | TA1714 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |