Florida Eye Lab LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

FLORIDA EYE LAB LLC

Doing business as

My Eye Lab

Practice address

3321 SW Archer Rd
Gainesville, FL 32608-1745

Phone

(561) 275-2020

NPI assigned

May 28, 2018

Organization subpart

No

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

Authorized official

Name

Jackie Bennett

Title

Credentialing Specialist

Phone

(561) 433-6009

Specialties & licenses 1

Addresses

Other names 1

• My Eye Lab Doing business as

Locations

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

{
    "created_epoch": "1527465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527465600000",
    "number": "1124519988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081745",
            "telephone_number": "561-275-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3321 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081745",
            "telephone_number": "561-275-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA EYE LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-28",
        "last_updated": "2018-05-28",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "561-433-6009"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Eye Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Florida Department of Health
• Florida Department of Health
• Florida Department of Health
• Florida Em-I Medical Services, PA
• Florida Eye Care and Surgery Inc
• Florida Eyeglass Corporation
• Florida Health Professionals Association Inc
• Florida Health Professions Association, Inc.
• Florida Health Professions Association, Inc.
• Florida Healthcare Consultants LLC

• Optometrist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2018; 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.