NPIMap

Organization Active NPI

Tri County Eye Associates PA

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1164570636
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TRI COUNTY EYE ASSOCIATES PA
Practice address
1403 Dunn Ave.
Unit 15
Jacksonville, FL 32218-4870
Phone
(904) 696-0883
Fax
(904) 696-9283
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dawn Debolle
Title
Lab Technician
Phone
(904) 696-0883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1403 Dunn Ave.
Unit 15
Jacksonville, FL 32218-4870

Mailing address

1403 Dunn Ave.
Unit 15
Jacksonville, FL 32218-4870
Phone (904) 696-0883

National Provider Directory

National Provider Directory
Tax ID family
Tri County Eye Associates PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1403 Dunn Ave
Ste 15
Jacksonville, FL 32218
Phone (904) 696-0883

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164570636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 DUNN AVE.",
            "address_2": "UNIT 15",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184870",
            "telephone_number": "904-696-0883",
            "fax_number": "904-696-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 DUNN AVE.",
            "address_2": "UNIT 15",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184870",
            "telephone_number": "904-696-0883",
            "fax_number": "904-696-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY EYE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEBOLLE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "LAB TECHNICIAN",
        "authorized_official_telephone_number": "904-696-0883"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • 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.