20/20 Eyeglass Superstore, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

OE874 Issued in FL

Legal business name

20/20 EYEGLASS SUPERSTORE, INC.

Practice address

1555 N. Semoran Blvd.
Suite 1221
Winter Park, FL 32792

Phone

(407) 767-5600

Fax

(407) 331-0277

NPI assigned

Feb 2, 2007

Last updated

Aug 31, 2011By the provider in NPPES

Organization subpart

No

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 7

Addresses

Other identifiers 3

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1356489918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 N. SEMORAN BLVD.",
            "address_2": "SUITE 1221",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-767-5600",
            "fax_number": "407-331-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 N. SEMORAN BLVD.",
            "address_2": "SUITE 1221",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-767-5600",
            "fax_number": "407-331-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20/20 EYEGLASS SUPERSTORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-08-31",
        "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": "OE 874",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "OE874",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "0844",
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "FL",
            "license": "DO 5119",
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "FL",
            "license": "DO 2187",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO 2187",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO 5119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "20186",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "10654",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "FL0844",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Eyewear Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.