Organization Active NPI

First Image Optical LC

  • Durable Medical Equipment & Medical Supplies
  • Summerfield, FL
National Provider Identifier
1497937015
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
FIRST IMAGE OPTICAL LC
Practice address
17556 SE 109TH Terrace Rd
Summerfield, FL 34491-6907
Phone
(352) 735-2020
Fax
(352) 735-3233
NPI assigned
Dec 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
George L Neal
Title
President
Phone
(469) 214-0144

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

17556 SE 109TH Terrace Rd
Summerfield, FL 34491-6907

Mailing address

17562 Highway 441
Mount Dora, FL 32757-6711
Phone (352) 735-2020

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1497937015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17562 HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576711",
            "telephone_number": "352-735-2020",
            "fax_number": "352-735-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17556 SE 109TH TERRACE RD",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344916907",
            "telephone_number": "352-735-2020",
            "fax_number": "352-735-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST IMAGE OPTICAL LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-214-0144"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerfield, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.