Provider Demographics
NPI:1568854560
Name:CENTRAL FLORIDA PREMIER EYE ASSOCIATES
Entity Type:Organization
Organization Name:CENTRAL FLORIDA PREMIER EYE ASSOCIATES
Other - Org Name:PRECISION OPTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:VOCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-343-2020
Mailing Address - Street 1:3310 WATERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-5250
Mailing Address - Country:US
Mailing Address - Phone:352-343-2020
Mailing Address - Fax:352-343-4728
Practice Address - Street 1:801 COUNTY ROAD 466
Practice Address - Street 2:UNIT 102
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-305-2070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278334700Medicaid
FLK7385Medicare PIN