Broome Eye Care and Optical PA

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

1992167407 Issued in FL

Legal business name

BROOME EYE CARE AND OPTICAL PA

Practice address

125 SW Midtown PL
Suite 101
Lake City, FL 32025-0766

Phone

(386) 466-1062

Fax

(386) 466-1061

NPI assigned

Mar 23, 2016

Organization subpart

No

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

Authorized official

Name

Frank Anthony Broome, O.D.

Title

Owner

Phone

(386) 466-1062

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473379200000",
    "number": "1992167407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SW MIDTOWN PL",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250766",
            "telephone_number": "386-466-1062",
            "fax_number": "386-466-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SW MIDTOWN PL",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250766",
            "telephone_number": "386-466-1062",
            "fax_number": "386-466-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOME EYE CARE AND OPTICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-09-09",
        "status": "A",
        "authorized_official_last_name": "BROOME",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-466-1062",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "1679554760",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "1992167407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Brody, PH.D.
• Annie B Brooks, CMSW
• Carla Brooks
• Brookside Medical Center
• Taylor Chantell Broom
• Antoinette S Broome
• Frank Anthony Broome III, OD
• Amanda Cheyenne Brown, APRN
• Carla Brown
• Catherine Rose Brown, NURSE PRACTITIONER

• Preferred Provider Organization in Lake City, FL
• Providers in Lake City, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.