Active NPI
Vision Source Maitland, LLC
- Optometrist
- Maitland, FL
National Provider Identifier
1194597690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- VISION SOURCE MAITLAND, LLC
- Practice address
- 238 S Orlando Ave
Maitland, FL 32751 - Phone
- (407) 971-1001
- Fax
- (407) 971-1002
- NPI assigned
- Oct 27, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David N Fisher, OD
- Title
- Managing Member
- Phone
- (407) 462-3738
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
238 S Orlando Ave
Maitland, FL 32751
Mailing address
238 S Orlando Ave
Maitland, FL 32751-5604
Phone (407) 971-1001
Other practice location 1
1020 Lockwood Blvd
Oviedo, FL 32765-6027
Phone (407) 971-1001
Other names 1
- Vision Source
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Vision Source Maitland LLC
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Oviedo, FL
- NPI 1033283288
-
- Medical Specialty Clinic/Center
- Oviedo, FL
- NPI 1154124642
-
- Optometrist
- Winter Springs, FL
- NPI 1891582714
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Oviedo, FL
- NPI 1598875809
-
- Optometrist
- Oviedo, FL
- NPI 1003963307
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739836800000",
"number": "1194597690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "238 S ORLANDO AVE",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327515604",
"telephone_number": "407-971-1001",
"fax_number": "407-971-1002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "238 S ORLANDO AVE",
"city": "MAITLAND",
"state": "FL",
"postal_code": "32751",
"telephone_number": "407-971-1001",
"fax_number": "407-971-1002"
}
],
"practiceLocations": [
{
"address_1": "1020 Lockwood Blvd",
"address_purpose": "LOCATION",
"city": "Oviedo",
"state": "FL",
"postal_code": "327656027",
"country_code": "US",
"telephone_number": "407-971-1001",
"fax_number": "407-971-1002",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "VISION SOURCE MAITLAND, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-10-27",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A",
"authorized_official_last_name": "FISHER",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "407-462-3738",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Vision Source",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.