NPIMap

Organization Active NPI

St. Cloud Eye Center, Inc

Doing business as Eye Florida

  • Ophthalmology Physician
  • Saint Cloud, FL
National Provider Identifier
1518352210
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME94908 Issued in FL
Legal business name
ST. CLOUD EYE CENTER, INC
Doing business as
Eye Florida
Practice address
4589 Henry C Yates LN
Saint Cloud, FL 34769-6764
Phone
(407) 891-2010
Fax
(407) 891-8211
NPI assigned
Mar 31, 2015
Last updated
Mar 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Jessica Samuelson
Title
Office Manager
Phone
(407) 891-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME94908 FL Primary

Addresses

Primary practice location

4589 Henry C Yates LN
Saint Cloud, FL 34769-6764

Mailing address

4589 Henry C Yates LN
Saint Cloud, FL 34769-6764
Phone (407) 891-2010

Other identifiers 1

IdentifierTypeStateIssuer
003838000MedicaidFL

Other names 1

  • Eye Florida Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Cloud Eye Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1518352210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4589 HENRY C YATES LN",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696764",
            "telephone_number": "407-891-2010",
            "fax_number": "407-891-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4589 HENRY C YATES LN",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696764",
            "telephone_number": "407-891-2010",
            "fax_number": "407-891-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLOUD EYE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "SAMUELSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-891-2010"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME94908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003838000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.