Lake Nona Vision Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

4991 Issued in FL

Legal business name

LAKE NONA VISION INC

Practice address

11920 Narcoossee Rd
Orlando, FL 32832

Phone

(386) 334-2705

NPI assigned

Jan 10, 2017

Organization subpart

No

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

Authorized official

Name

Phung Minh Ho, ODNPI 1891196903

Title

President

Phone

(386) 334-2705

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

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

• Phung Minh Ho, OD

  • Optometrist
  • Oviedo, FL
  • NPI 1891196903
  NPD (past) Authorized official

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1477099877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 SEA DUCK DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321191328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11920 NARCOOSSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32832",
            "telephone_number": "386-334-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NONA VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "PHUNG",
        "authorized_official_middle_name": "MINH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-334-2705",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4991",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014476800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Nona Ophthalmology PL
• Lake Nona Psychiatric Associates, LLC
• Lake Nona Psychiatric Center, PA
• Lake Nona Spine Center, Inc.
• Lake Nona Surgery Center, LLC
• Joleen Marie Lake, A.P.R.N.
• Leah Lake, CERTIFIED NURSE ASSI
• Lakefront Medical Center PA
• Lakesha N. Richards
• Lakeside Med Supplies

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.