Exclusive Eyewear No. 1, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EXCLUSIVE EYEWEAR NO. 1, LLC

Doing business as

My EyeLab

Practice address

12233 W Sunrise Blvd
Plantation, FL 33323-2234

Phone

(954) 824-2400

Fax

(561) 828-8367

NPI assigned

Nov 24, 2020

Organization subpart

No

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

Authorized official

Name

Jackie Bennett

Title

Credentialing Manager

Phone

(561) 275-2020

Specialties & licenses 2

Addresses

Other names 1

• My EyeLab Doing business as

Tax ID family

Exclusive Eyewear No 1 LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Exclusive Eyewear No. 1, LLC

  • Eyewear Supplier
  • Plantation, FL
  • NPI 1316542210
  NPD tax ID

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1902400609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12233 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333232234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12233 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333232234",
            "telephone_number": "954-824-2400",
            "fax_number": "561-828-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCLUSIVE EYEWEAR NO. 1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-24",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "561-275-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My EyeLab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Excelsior HHA
• Exclusive Eyewear No. 1, LLC
• Expanded Counseling Solutions
• Express Mobile Phlebotomy Services
• Carmante Extra, DNP, ARNP, FNP-BC
• Exum Life Counseling, Mediation, & Training Services, Inc.
• Eye Associates of Plantation Inc

• Optometrist in Plantation, FL
• Providers in Plantation, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.