NPIMap

Organization Active NPI

Central Florida Premier Eye Associates

  • Durable Medical Equipment & Medical Supplies
  • Mount Dora, FL
National Provider Identifier
1609511708
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CENTRAL FLORIDA PREMIER EYE ASSOCIATES
Practice address
4900 N County Road 19a
Mount Dora, FL 32757-2042
Phone
(352) 483-3555
NPI assigned
May 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Authorized official

Name
Scot Corbin Holman
Title
Owner
Phone
(352) 343-4798

Specialties & licenses 1

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

Addresses

Primary practice location

4900 N County Road 19a
Mount Dora, FL 32757-2042

Mailing address

1852 Mayo Dr
Tavares, FL 32778-4320

Other names 1

  • Lake Eye Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Florida Premier11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1651536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1609511708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1852 MAYO DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 N COUNTY ROAD 19A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572042",
            "telephone_number": "352-483-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA PREMIER EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "SCOT",
        "authorized_official_middle_name": "CORBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-343-4798"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.