Organization Active NPI

Fort Lauderdale Eye Care and Eyewear, LLC

  • Optometrist
  • Ft Lauderdale, FL
National Provider Identifier
1306154588
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2885 Issued in FL
Legal business name
FORT LAUDERDALE EYE CARE AND EYEWEAR, LLC
Practice address
1489 SE 17TH St
Suite 2J
Ft Lauderdale, FL 33316-1734
Phone
(954) 763-2842
NPI assigned
Sep 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Dr. Dawn Bearden, O.D.
Title
President
Phone
(954) 303-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC2885 FL Primary

Addresses

Primary practice location

1489 SE 17TH St
Suite 2J
Ft Lauderdale, FL 33316-1734

Mailing address

209 N Fort Lauderdale Beach Blvd
Unit 11G
Ft Lauderdale, FL 33304-4365
Phone (954) 303-6600

National Provider Directory

National Provider Directory

Locations

1489 SE 17th St
Ste 2J
Ft Lauderdale, FL 33316
Phone (954) 763-2842

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1306154588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 N FORT LAUDERDALE BEACH BLVD",
            "address_2": "UNIT 11G",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333044365",
            "telephone_number": "954-303-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 SE 17TH ST",
            "address_2": "SUITE 2J",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161734",
            "telephone_number": "954-763-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LAUDERDALE EYE CARE AND EYEWEAR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "BEARDEN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-303-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

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