Florida Ophthalmic Affiliates, PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME85614 Issued in FL

Legal business name

FLORIDA OPHTHALMIC AFFILIATES, PA

Practice address

1300 Shoreline Drive
Suite 104
Gulf Breeze, FL 32561-4766

Phone

(855) 989-2020

Fax

(855) 290-5952

NPI assigned

Aug 13, 2012

Last updated

Jul 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Michael Mills, MDNPI 1639118227

Title

Owner

Phone

(855) 989-2020

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David M Mills, M.D.

  • Ophthalmology Physician
  • Pensacola, FL
  • NPI 1639118227
  Medicare reassignment NPD Authorized official
• Wesley Thomas Mayes, O.D.

  • Optometrist
  • Pensacola, FL
  • NPI 1780876862
  Medicare reassignment NPD

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1689921389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW",
            "address_2": "SUITE 38",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485200",
            "telephone_number": "855-989-2020",
            "fax_number": "855-989-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SHORELINE DRIVE",
            "address_2": "SUITE 104",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614766",
            "telephone_number": "855-989-2020",
            "fax_number": "855-290-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA OPHTHALMIC AFFILIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-989-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME85614",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME85614",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006482201",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006482200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hollie Shelton Fletcher, PHARM.D.
• Carrie Lyn Fleury, LPC
• Angie Flores, RPH
• Arlene F Flores, ARNP
• Florida ABA Therapy LLC
• Tracy N Fox Nelson, P.A.
• Frank Lachowsky M.D., P.a.
• Myron Franklin, OTR/L
• Richard Lee Freeman II
• Rachel Fuller, COTA/L

• Ophthalmology Physician in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.