Family Vision Services, P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP0482 Issued in FL

Legal business name

FAMILY VISION SERVICES, P.A.

Practice address

301 Eagle Ridge Dr
Lake Wales, FL 33859-4751

Phone

(863) 679-2068

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Iris Matsukado, O.D.NPI 1932131521

Title

President

Phone

(813) 340-1025

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Iris Matsukado, O.D.

  • Optometrist
  • Tampa, FL
  • NPI 1932131521
  NPD (past) Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124234612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12718 BRAMFIELD DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335697776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EAGLE RIDGE DR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338594751",
            "telephone_number": "863-679-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATSUKADO",
        "authorized_official_first_name": "IRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-340-1025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP0482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "OP0482",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.