NPIMap

Organization Active NPI

Eagle Optical Co.

  • Eyewear Supplier
  • Tampa, FL
National Provider Identifier
1578747309
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
DO 2954 Issued in FL
Legal business name
EAGLE OPTICAL CO.
Practice address
1410 E Fletcher Ave
Tampa, FL 33612-3668
Phone
(813) 977-4801
NPI assigned
Dec 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Authorized official

Name
Mr. Roger Wayne Frey, LDONPI 1144366964
Title
President
Phone
(813) 977-4801

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X DO 2954 FL Primary

Addresses

Primary practice location

1410 E Fletcher Ave
Tampa, FL 33612-3668

Mailing address

1410 E Fletcher Ave
Tampa, FL 33612-3668
Phone (813) 977-4801

National Provider Directory

National Provider Directory

Locations

1410 E Fletcher Ave
Tampa, FL 33612
Phone (813) 977-4801

Practitioners & affiliated clinicians

Practitioners 2

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": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1578747309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123668",
            "telephone_number": "813-977-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123668",
            "telephone_number": "813-977-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE OPTICAL CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-977-4801",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "DO 2954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.