Organization Active NPI

Second Optometric Care of Florida PA

  • Optometrist
  • Niceville, FL
National Provider Identifier
1548027873
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SECOND OPTOMETRIC CARE OF FLORIDA PA
Practice address
1103 John Sims Pkwy E
Niceville, FL 32578-2752
Phone
(850) 279-4361
NPI assigned
Mar 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Brittany Harrison
Title
Director
Phone
(512) 316-4603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1103 John Sims Pkwy E
Niceville, FL 32578-2752

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985
Phone (916) 851-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250519003173 FL Part B Supplier - Clinic/Group Practice 7719405166 Receives reassigned benefits from 2 practitioners
Practice locations: Niceville, FL

National Provider Directory

National Provider Directory
Tax ID family
Second Optometric Care of Florida PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1548027873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 QUALITY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707985",
            "telephone_number": "916-851-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 JOHN SIMS PKWY E",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782752",
            "telephone_number": "850-279-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND OPTOMETRIC CARE OF FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "512-316-4603"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.