Eye Site Center, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

OPC2762 Issued in FL

Legal business name

EYE SITE CENTER, INC.

Practice address

9433 Balm Riverview Rd Ste 102
Riverview, FL 33569-5120

Phone

(813) 677-2995

Fax

(813) 677-5549

NPI assigned

Jun 24, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Mark S. Luedke

Title

Pres

Phone

(813) 677-2995

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1982915922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9433 BALM RIVERVIEW RD STE 102",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695120",
            "telephone_number": "813-677-2995",
            "fax_number": "813-677-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9433 BALM RIVERVIEW RD STE 102",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695120",
            "telephone_number": "813-677-2995",
            "fax_number": "813-677-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SITE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-24",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "LUEDKE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "813-677-2995",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "OPC2762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Florida

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