First Image Optical LC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FIRST IMAGE OPTICAL LC

Practice address

5743 Williamsburg LN
Wildwood, FL 34785-8129

Phone

(352) 744-7002

NPI assigned

Mar 27, 2017

Organization subpart

No

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

Authorized official

Name

George L Neal

Title

President

Phone

(469) 214-0144

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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

• Jeffrey D Baumann, MD

  • Ophthalmology Physician
  • Mount Dora, FL
  • NPI 1841293974
  NPD (past)
• Keith C Charles, MD

  • Ophthalmology Physician
  • Mount Dora, FL
  • NPI 1255334389
  NPD (past)

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1194256545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17562 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576711",
            "telephone_number": "352-735-2020",
            "fax_number": "352-735-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5743 WILLIAMSBURG LN",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858129",
            "telephone_number": "352-744-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST IMAGE OPTICAL LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-214-0144"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerrold Randall Ecklind, D.O.
• Exalt Health Rehabilitation Hospital Wildwood LLC
• Yaidy Exposito, O.D.
• Expovision & Eyecare LLC
• F.Q.S Cares LLC
• Hany Gabriel, DDS
• Mirakle Gadson, LPN
• Algernon M Gilmer
• Mariel Gonzalez-Mendoza, MD
• Christina Gwyn, SLP

• All providers in Wildwood, FL
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.