Myeyedr. Optometry of Florida, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MYEYEDR. OPTOMETRY OF FLORIDA, LLC

Practice address

2629 N Forest Ridge Blvd
Hernando, FL 34442-5123

Phone

(352) 527-2775

Fax

(352) 527-2788

NPI assigned

Jan 27, 2016

Organization subpart

No

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

Authorized official

Name

Sue Downes

Title

Secretary

Phone

(703) 847-8899

Specialties & licenses 1

Addresses

Other names 1

• MyEyeDr. Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1376900951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-233-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 N FOREST RIDGE BLVD",
            "city": "HERNANDO",
            "state": "FL",
            "postal_code": "344425123",
            "telephone_number": "352-527-2775",
            "fax_number": "352-527-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR. OPTOMETRY OF FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-27",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sanggiu Moon
• Carlos Morales
• Jessica Lynn Morales, MA
• John Mosley Jr.
• Liza A. Mozingo, MPA, PA-C
• Anna Elizabeth Newlon
• Shawn Marie Niccolls, LCSW
• Matthew Nixon, DC
• Bharat V Parikh, MD
• Won H Park, M.D.

• Optometrist in Hernando, FL
• Providers in Hernando, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.

Verify at the official NPI Registry.