3D Vision Eye Surgery Center

Key facts

NPI: 1245569508
Entity type: Organization (NPI type 2)
Primary specialty: Ophthalmology Physician 207W00000X
License: ME80695 (FL)
Legal business name: 3D VISION EYE SURGERY CENTER
Practice address: 1201 S Ridgewood Ave
Daytona Beach, FL 32114-6123
Phone: (386) 492-7718
Fax: (386) 492-7720
NPI assigned: Dec 16, 2009
Organization subpart: No

Authorized official

Name: Dr. Allen Thomas Jackson, M.D.
Title: Director
Phone: (386) 492-7718

Practitioners 2

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

Allen Thomas Jackson, MD Ophthalmology Physician · Daytona Beach, FL · NPI 1932151479

Medicare reassignment NPD FL · OPHTHALMOLOGY
Marie Lauretta Seide-Justin, O.D. Optometrist · Orlando, FL · NPI 1760423271

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20100409000031	FL	Part B Supplier - Clinic/Group Practice	2769526797	Receives reassigned benefits from 1 practitioner Practice locations: Daytona Beach, FL

National Provider Directory

Locations

1201 S Ridgewood Ave
Daytona Beach, FL 32114
Phone (386) 492-7718

6601 Old Winter Garden Rd
Ste 104
Orlando, FL 32835
Phone (407) 292-9812

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Ophthalmology Physician Group: 193400000X SINGLE SPECIALTY GROUP	207W00000X	ME80695	FL	Yes

Addresses

Primary practice location

1201 S Ridgewood Ave
Daytona Beach, FL 32114-6123

Mailing address

1201 S Ridgewood Ave
Daytona Beach, FL 32114-6123
Phone (386) 492-7718

Other names

FERST: Florida Eye Research and Surgical Therapy Institute Doing business as

Other providers in Daytona Beach, FL

All providers in Daytona Beach, FL · Ophthalmology Physician in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.