NPIMap

Organization Active NPI

Eye Associates of Mid Florida, P.a.

  • Optometrist
  • Orlando, FL
National Provider Identifier
1902359003
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4482 Issued in FL
Legal business name
EYE ASSOCIATES OF MID FLORIDA, P.A.
Practice address
11794 E Colonial Dr
Orlando, FL 32817-4626
Phone
(407) 904-4431
Fax
(407) 904-4438
NPI assigned
Jul 26, 2016
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Dr. Brandon Eb Mondesir, O.D.NPI 1992967038
Title
Owner
Phone
(407) 904-4431

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4482 FL Primary

Addresses

Primary practice location

11794 E Colonial Dr
Orlando, FL 32817-4626

Mailing address

11794 E Colonial Dr
Orlando, FL 32817-4626
Phone (407) 904-4431

Other identifiers 1

IdentifierTypeStateIssuer
016166600MedicaidFL

National Provider Directory

National Provider Directory

Locations

11794 E Colonial Dr
Orlando, FL 32817
Phone (407) 904-4431

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1902359003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11794 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174626",
            "telephone_number": "407-904-4431",
            "fax_number": "407-904-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11794 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174626",
            "telephone_number": "407-904-4431",
            "fax_number": "407-904-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF MID FLORIDA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "MONDESIR",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "EB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-904-4431",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016166600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.