Community Eye Dispensary

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

COMMUNITY EYE DISPENSARY

Practice address

21275 Olean Blvd
Port Charlotte, FL 33952-6704

Phone

(727) 755-0693

NPI assigned

Mar 22, 2016

Organization subpart

No

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

Authorized official

Name

Ariana Bedoya

Title

Credentialing Manager

Phone

(727) 755-0693

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1659733392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PARK PLACE BLVD FL 5",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594904",
            "telephone_number": "727-755-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21275 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526704",
            "telephone_number": "727-755-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY EYE DISPENSARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "BEDOYA",
        "authorized_official_first_name": "ARIANA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "727-755-0693"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.