Family Vision Institute of South Florida Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4217 Issued in FL

Legal business name

FAMILY VISION INSTITUTE OF SOUTH FLORIDA INC.

Doing business as

Vision Source Fort Lauderdale

Practice address

640 N Federal Hwy
Fort Lauderdale, FL 33304-4686

Phone

(954) 522-3918

Fax

(954) 522-5137

NPI assigned

Jan 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Brandon William Cornish, O.D.NPI 1396937470

Title

Ceo

Phone

(954) 522-3918

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vision Source Fort Lauderdale Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Brandon William Cornish, O.D.

  • Optometrist
  • Fort Lauderdale, FL
  • NPI 1396937470
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1386821379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333044686",
            "telephone_number": "954-522-3918",
            "fax_number": "954-522-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333044686",
            "telephone_number": "954-522-3918",
            "fax_number": "954-522-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION INSTITUTE OF SOUTH FLORIDA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "CORNISH",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-522-3918",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621267100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Source Fort Lauderdale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Family Foundation Center
• Family Home Health Services LLC
• Family Matters Counseling P.a.
• Family Pharmacy LLC
• Family Pillars Homecare Broward, LLC. (Family Pillars Homecare)
• Suleidy Fana Suero, LCMHC
• Leilani Fandino, MS LMHC
• Stefano Fanfoni, LMFT, PHD CANDIDATE
• Mathew Farbman
• Petrine Fardette, PA C

• Optometrist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.