Organization Active NPI

Eye Candy Optical LLC

  • Optician
  • Fort Walton Beach, FL
National Provider Identifier
1104002260
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
EYE CANDY OPTICAL LLC
Practice address
80 Beal Pkwy NW
Suite E
Fort Walton Beach, FL 32548-4829
Phone
(850) 226-7096
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Candice L Reeve, LICENSED OPTICIAN
Title
Owner
Phone
(850) 226-7096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

80 Beal Pkwy NW
Suite E
Fort Walton Beach, FL 32548-4829

Mailing address

80 Beal Pkwy NW
Suite E
Fort Walton Beach, FL 32548-4829
Phone (850) 226-7096

National Provider Directory

National Provider Directory

Locations

80 Beal Pkwy NW
Ste E
Fort Walton Beach, FL 32548
Phone (850) 226-7096

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1104002260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BEAL PKWY NW",
            "address_2": "SUITE E",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484829",
            "telephone_number": "850-226-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BEAL PKWY NW",
            "address_2": "SUITE E",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484829",
            "telephone_number": "850-226-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CANDY OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "REEVE",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-226-7096",
        "authorized_official_credential": "LICENSED OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.