Millennium Eye Center, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC003955 Issued in FL

Legal business name

MILLENNIUM EYE CENTER, INC.

Practice address

6601 Old Winter Garden Rd
Suit 104
Orlando, FL 32835-1221

Phone

(407) 292-9812

Fax

(407) 292-9813

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marie Lauretta Seide-Justin, O.D.NPI 1760423271

Title

President

Phone

(407) 292-9812

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marie Lauretta Seide-Justin, O.D.

  • Optometrist
  • Orlando, FL
  • NPI 1760423271

  FL, Optometrist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1790721652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 OLD WINTER GARDEN RD",
            "address_2": "SUIT 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328351221",
            "telephone_number": "407-292-9812",
            "fax_number": "407-292-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 OLD WINTER GARDEN RD",
            "address_2": "SUIT 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328351221",
            "telephone_number": "407-292-9812",
            "fax_number": "407-292-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM EYE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "SEIDE-JUSTIN",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "LAURETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-292-9812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC003955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621147000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Millenium Rehab & Wellness Center LLC
• Millennial Behavioral Services LLC
• Abigail Grey Miller
• Adam Miller
• Adam Matthew Miller, LMHC
• Aimee Miller, AUD, CCC-A, LMHC
• Ainsley Faith Miller

• All providers in Orlando, FL
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.