Eye Health & Vision Center PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1776 Issued in FL

Legal business name

EYE HEALTH & VISION CENTER PA

Practice address

107 Shamrock Blvd
Venice, FL 34293-1630

Phone

(941) 493-3763

Fax

(941) 492-9179

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David Mark Rubin, O.D.

Title

President

Phone

(941) 493-3763

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1659492502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SHAMROCK BLVD",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342931630",
            "telephone_number": "941-493-3763",
            "fax_number": "941-492-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SHAMROCK BLVD",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342931630",
            "telephone_number": "941-493-3763",
            "fax_number": "941-492-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE HEALTH & VISION CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-493-3763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078478800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "580001929",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "AG551",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.