NPIMap

Organization Active NPI

Eye Specialists of Mid Florida, PA

  • Optometrist
  • Lakeland, FL
National Provider Identifier
1609494566
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE SPECIALISTS OF MID FLORIDA, PA
Practice address
3350 Harden Blvd
Lakeland, FL 33803-7939
Phone
(863) 294-3504
NPI assigned
Jul 8, 2020
Last updated
Jul 8, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
EYE SPECIALISTS OF MID FLORIDA, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Authorized official

Name
Rosa Torres
Title
Credentialing Specialist
Phone
(863) 294-3504

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Ophthalmology Physician 207W00000X NU

Addresses

Primary practice location

3350 Harden Blvd
Lakeland, FL 33803-7939

Mailing address

407 Avenue K SE
Winter Haven, FL 33880-4126
Phone (863) 294-3504

National Provider Directory

National Provider Directory
Tax ID family
Eye Clinic of Mid Flori6 organizations share this tax ID, including this one
Part of
Eye Clinic of Mid Flori

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1609494566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804126",
            "telephone_number": "863-294-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338037939",
            "telephone_number": "863-294-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SPECIALISTS OF MID FLORIDA, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE SPECIALISTS OF MID FLORIDA, PA",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "ROSA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "863-294-3504"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.