Super Optical Express

Primary specialty

OptometristTaxonomy code 152W00000X

License

796 Issued in FL

Legal business name

SUPER OPTICAL EXPRESS

Practice address

6757 W Newberry Rd
Gainesville, FL 32605-4312

Phone

(352) 331-2040

Fax

(352) 331-1526

NPI assigned

Aug 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Paul E Funderburk, O.D.NPI 1376571752

Title

Vice President

Phone

(352) 331-2040

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 4

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

• Paul Edward Funderburk, O.D

  • Optometrist
  • Gainesville, FL
  • NPI 1376571752
  NPD (past) Authorized official
• Jose Roberto Arnao, O.D.

  • Corneal and Contact Management Optometrist
  • Gainesville, FL
  • NPI 1417185364
  NPD (past)
• Bradley P Bangstad, O.D.

  • Optometrist
  • Gainesville, FL
  • NPI 1013935006
  NPD (past)
• John Buckner, O.D.

  • Ophthalmic Technician/Technologist
  • Gainesville, FL
  • NPI 1194850388
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1639325434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6757 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054312",
            "telephone_number": "352-331-2040",
            "fax_number": "352-331-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6757 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054312",
            "telephone_number": "352-331-2040",
            "fax_number": "352-331-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER OPTICAL EXPRESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "FUNDERBURK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "352-331-2040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084305900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084871900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunrise Community, Inc.
• Sunshine Integrative Health, Inc.
• Sunstate Nursing Services, P.a.
• Saroja Suntharam, MD
• Super Fun Friendship Guild Inc.
• Swapna Surabhi
• Anna Surento, LMT
• Surgery Center of North Florida, Inc.
• Jacob Surges, M.D.
• Surgical Center of North Florida, LLC (Surgical Center of North Florida)

• Optometrist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.