NPIMap

Organization Active NPI

411 Eyes, LLC.

Doing business as 20/20 Eyeglass Superstore, Inc.

  • Eyewear Supplier
  • Orange City, FL
National Provider Identifier
1184904260
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
OE 2002 Issued in FL
Legal business name
411 EYES, LLC.
Doing business as
20/20 Eyeglass Superstore, Inc.
Practice address
1270 Saxon Blvd
Suite 105
Orange City, FL 32763-8418
Phone
(386) 774-5000
Fax
(386) 774-0444
NPI assigned
Aug 22, 2011
Last updated
Nov 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Mr. Edward Ucci, ABOC NCLE
Title
General Manager
Phone
(407) 767-5600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X DO 5119 FL
Eyewear Supplier 332H00000X OE 2002 FL Primary
Optometrist 152W00000X 2732 FL

Addresses

Primary practice location

1270 Saxon Blvd
Suite 105
Orange City, FL 32763-8418

Mailing address

1270 Saxon Blvd
Suite 105
Orange City, FL 32763-8418
Phone (386) 774-5000

Other names 1

  • 20/20 Eyeglass Superstore, Inc. Doing business as

National Provider Directory

National Provider Directory

Locations

1270 Saxon Blvd
Ste 105
Orange City, FL 32763
Phone (386) 774-5000

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1184904260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 SAXON BLVD",
            "address_2": "SUITE 105",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638418",
            "telephone_number": "386-774-5000",
            "fax_number": "386-774-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 SAXON BLVD",
            "address_2": "SUITE 105",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638418",
            "telephone_number": "386-774-5000",
            "fax_number": "386-774-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "411 EYES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "UCCI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "407-767-5600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ABOC NCLE"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "DO 5119",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "OE 2002",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2732",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "20/20 Eyeglass Superstore, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.