BEACON VISION CENTER, INC (NPI# 1114962677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114962677 |
| Entity Type | Organization |
| Organization Name | BEACON VISION CENTER, INC |
| Other Organization Name | BEACON ADVANCED EYECARE |
| Practice Address |
1320 Shelfer St Leesburg FL 34748-3929 |
| Mailing Address |
1320 Shelfer St Beacon Advanced Eye Care Leesburg FL 34748-3929 |
| Practice Telephone | 3527288318 |
| Practice Fax Number | 3527280057 |
| Mailing Telephone | 3527288318 |
| Mailing Fax Number | 3527280057 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2009-12-18 |
| Authorized Official Name | MR. JOHN J. NAUMANN (CORP SEC) |
| Authorized Official Telephone | 3527288318 |
| Authorized Official Credential | OPTICIAN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 335E00000X | Prosthetic/Orthotic Supplier | 1146 | FL | Suppliers |
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 630288200 | 05 |
| Other Name | Type Code |
|---|---|
| Beacon Advanced Eyecare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649215104 | Beacon Vision Center, Inc | Prosthetic/Orthotic Supplier | 1128 Bichara Blvd, The Villages, FL 32159-7716 | 2006-06-18 |
| Street Address |
1320 SHELFER ST |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-3929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033151394 | Albert Richard Ducharme | Optometrist | 1320 Shelfer St, Leesburg, FL 34748-3929 | 2006-06-12 |
| 1245870641 | Myeyedr Optometry of Florida, LLC | Optometrist | 1320 Shelfer St, Leesburg, FL 34748-3929 | 2020-01-14 |
| 1487044129 | Albert R Ducharme | Optometrist | 1320 Shelfer St, Leesburg, FL 34748-3929 | 2015-02-03 |
| 1033390190 | James Kevin Berry | Optometrist | 1320 Shelfer St, Leesburg, FL 34748-3929 | 2007-11-16 |
| 1235245259 | James K. Berry Od, Pa | Optometrist | 1320 Shelfer St, Leesburg, FL 34748-3929 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083915110 | Daniel Poth, O.d. and Associates, P.C. | Eyewear Supplier (Equipment, not the service) | 1607 Village Market Blvd Se, Suite 124, Leesburg, VA 20175-4667 | 2010-11-05 |
| 1386798460 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 10041 Us Hwy 441, Suite E, Leesburg, FL 34788 | 2007-01-23 |
| 1053476358 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 10401-334 441 S, Leesburg, FL 34788-8787 | 2006-12-27 |
| 1689748022 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 10401 2002 Us441, Lake Square Mall, Leesburg, FL 34788-4788 | 2006-11-18 |
| 1548654874 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1300 Edwards Ferry Rd Ne, Leesburg, VA 20176-3355 | 2015-03-25 |
| 1164574133 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 1200 Edwards Ferry Rd Ne, Leesburg, VA 20176-3318 | 2007-01-18 |
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|---|---|---|---|---|
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| 1619575859 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2577 S Highway 27, Clermont, FL 34711-6788 | 2020-10-10 |
| 1689272825 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 6290 Commerce Palms Dr, Tampa, FL 33647-1506 | 2020-10-10 |
| 1548868789 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 9372 Ben C Pratt/6 Mile Cypress Pkwy, Fort Myers, FL 33966-6502 | 2020-10-10 |
| 1003413444 | Family Vision of Crestview LLC | Eyewear Supplier (Equipment, not the service) | 535 S Ferdon Blvd Ste B, Crestview, FL 32536-4446 | 2020-10-08 |
| 1891392478 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 650 Se 8th St, Homestead, FL 33030-7405 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.