Broome Vision Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3301 Issued in FL

Legal business name

BROOME VISION INC.

Practice address

3781O S Nova Rd Ste O
Port Orange, FL 32129-4233

Phone

(386) 760-8626

Fax

(386) 760-2676

NPI assigned

Jul 8, 2008

Organization subpart

No

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

Authorized official

Name

Kevin Andrew Broome, O.D.

Title

President/Owner

Phone

(386) 253-5999

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Broome Vision Inc

  • Optometrist
  • Orange City, FL
  • NPI 1407010119

  O20080903000609

  Same enrollment
• Broome Vision Inc

  • Optometrist
  • Ormond Beach, FL
  • NPI 1689838393

  O20080903000609

  Same enrollment
• Broome Vision Inc

  • Optometrist
  • Daytona Beach, FL
  • NPI 1922278704

  O20080903000609

  Same enrollment

Tax ID family

Broome Vision Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Broome Vision Inc

  • Optometrist
  • Orange City, FL
  • NPI 1407010119
  NPD tax ID
• Broome Vision Inc

  • Optometrist
  • Ormond Beach, FL
  • NPI 1689838393
  NPD tax ID
• Broome Vision Inc

  • Optometrist
  • Daytona Beach, FL
  • NPI 1922278704
  NPD tax ID

Locations

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1891958963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3781 S NOVA RD STE O",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294285",
            "telephone_number": "386-760-8626",
            "fax_number": "386-760-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3781O S NOVA RD STE O",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294233",
            "telephone_number": "386-760-8626",
            "fax_number": "386-760-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOME VISION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "BROOME",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "386-253-5999",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000206403",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lionel T Briones
• Frances Briseus
• Lauren Brizzolara
• Brookdale Senior Living Communities, Inc.
• Brandi Brooks, RBT
• Frank Anthony Broome Jr., O.D.
• Amanda Brown
• Ayrica Brown
• Edna Lippi Brown, L.M.H.C.
• Lakeitha Brown

• Optometrist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.