Organization Active NPI

Premier Eye Care of Florida LLC

  • Exclusive Provider Organization
  • Coral Gables, FL
National Provider Identifier
1932363934
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
PREMIER EYE CARE OF FLORIDA LLC
Practice address
4565 Ponce de Leon Blvd Ste 200
Coral Gables, FL 33146-1855
Phone
(561) 455-9002
NPI assigned
Jul 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Jason Panos
Title
Coo
Phone
(561) 455-9002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X Primary

Addresses

Primary practice location

4565 Ponce de Leon Blvd Ste 200
Coral Gables, FL 33146-1855

Mailing address

PO Box 980216
West Sacramento, CA 95798-0216
Phone (561) 455-9002

Other identifiers 1

IdentifierTypeStateIssuer
125168900MedicaidFL

National Provider Directory

National Provider Directory

Locations

6501 Park of Commerce Blvd
Fl First
Boca Raton, FL 33487

4565 Ponce de Leon Blvd
Ste 200
Coral Gables, FL 33146
Phone (561) 455-9002

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1932363934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980216",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "957980216",
            "telephone_number": "561-455-9002",
            "fax_number": "800-523-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 PONCE DE LEON BLVD STE 200",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461855",
            "telephone_number": "561-455-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYE CARE OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-18",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "PANOS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "561-455-9002"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125168900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; 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.