First Coast Optical LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

FIRST COAST OPTICAL LLC

Practice address

179 College Dr Ste 17
Orange Park, FL 32065-7690

Phone

(904) 272-7626

NPI assigned

Oct 5, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Michael Lundberg

Title

General Manager

Phone

(904) 272-7626

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1730639592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 COLLEGE DR STE 17",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657690",
            "telephone_number": "904-272-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 COLLEGE DR STE 17",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657690",
            "telephone_number": "904-272-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "LUNDBERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "904-272-7626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sarah Fishwild

• Optician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.