Eyes at Centerville Park LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME68965 Issued in FL

Legal business name

EYES AT CENTERVILLE PARK LLC

Practice address

2535 Capital Medical Blvd
Tallahassee, FL 32308-4624

Phone

(850) 877-7337

Fax

(850) 877-8675

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard Mark Palmer, MD

Title

Ceo

Phone

(850) 877-7337

Specialties & licenses 1

Addresses

Other names 1

• Palmer Eye Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Ethredge Matthews, M.D.

  • Ophthalmology Physician
  • Tallahassee, FL
  • NPI 1982866638
  Medicare reassignment Care Compare group NPD
• Whitney Whitfield, MD

  • Ophthalmology Physician
  • Tallahassee, FL
  • NPI 1285168773

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Tiffany T Malone, OD

  • Optometrist
  • Tallahassee, FL
  • NPI 1205831153
  Medicare reassignment NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278460800000",
    "number": "1124125406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084624",
            "telephone_number": "850-877-7337",
            "fax_number": "850-877-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084624",
            "telephone_number": "850-877-7337",
            "fax_number": "850-877-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYES AT CENTERVILLE PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-07-07",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-877-7337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME68965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmer Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evita Med Spa
• Roshonda Exantus, MS, ATC, LAT
• Paulette Exile
• Extended Care Portfolio Tenant, LLC
• Eye Associates of Tallahassee, P.a. Dba Eye Associates of North Florida
• F & G Professional Care Coordinators LLC
• Ellen D Faber, NCMT
• Ora Fabian Enaytzadah, LMT
• Yanira Candelaria Fabozzi
• Taylor Fabrega

• Ophthalmology Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.