Advanced Eye Care of Central Florida Inc
Organization Active NPI Optometrist · Sanford, FL
NPI 1750577490 · NPPES record last updated Apr 13, 2020
Key facts
- NPI
- 1750577490
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- OPC 3069 (FL)
- Legal business name
- ADVANCED EYE CARE OF CENTRAL FLORIDA INC
- Practice address
- 5680 Wayside Dr
Sanford, FL 32771-8625 - Phone
- (407) 333-3937
- Fax
- (407) 333-4500
- NPI assigned
- Sep 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Christy L Larson, O.D.
- Title
- Owner
- Phone
- (407) 333-3937
Practitioners 4
-
Ben L Larson, O.D.
-
Christy L Larson, O.D.
-
Tammy Le Phan, O.D.
-
Neelam Patel, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071210000110 | FL | Part B Supplier - Clinic/Group Practice | 4385733625 |
Receives reassigned benefits from 3 practitioners Practice locations: Sanford, FL |
National Provider Directory
Locations
570 Rinehart Rd
Ste 100
Lake Mary, FL 32746
Phone (407) 333-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | OPC 3069 | FL | Yes |
| Optometrist |
152W00000X | OPC 3015 | FL |
Addresses
Primary practice location
5680 Wayside Dr
Sanford, FL 32771-8625
Mailing address
5680 Wayside Dr
Sanford, FL 32771-8625
Phone (407) 333-3937
Other providers in Sanford, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.