CABANA EYES OPTICAL (NPI# 1154867554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154867554 |
| Entity Type | Organization |
| Organization Name | CABANA EYES OPTICAL |
| Practice Address |
4100 S Ferdon Blvd Suite B5 Crestview FL 32536-5252 |
| Practice Telephone | 8507580474 |
| Practice Fax Number | 8508260057 |
| Mailing Telephone | 8503062580 |
| Mailing Fax Number | 8504230142 |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2019-10-23 |
| Authorized Official Name | MR. EDWARD MITCHELL JR. (OWNER/ VISUAL RESOURCE DIRECTOR) |
| Authorized Official Telephone | 8507580474 |
| Authorized Official Credential | LDO |
| Is Organization Subpart | Y |
| Parent Organization Name | EDWARD MITCHELL JR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 003088900 | 05 |
| Street Address |
4100 S FERDON BLVD SUITE B5 |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32536-5252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316996713 | Prime Therapy Inc | Physical Therapist | 4100 S Ferdon Blvd, Ste A1, Crestview, FL 32536-5252 | 2006-05-10 |
| 1114559465 | Jordan Taylor | Behavior Technician | 4100 S Ferdon Blvd, Crestview, FL 32536-5252 | 2020-02-05 |
| 1538710108 | Aubree A Davis | Behavior Technician | 4100 S Ferdon Blvd, Crestview, FL 32536-5252 | 2019-09-25 |
| 1396396495 | Desiray Lavon Greer | Behavior Technician | 4100 S Ferdon Blvd, Crestview, FL 32536-5252 | 2019-09-20 |
| 1184013385 | Allison Rivers | Speech-Language Pathologist | 4100 S Ferdon Blvd, Crestview, FL 32536-5252 | 2015-01-12 |
| 1821409228 | Nikki Leigh Justice | Speech-Language Pathologist | 4100 S Ferdon Blvd, Suite C1, Crestview, FL 32536-5252 | 2014-05-20 |
| 1770834988 | Courtney Celeste Miller | Occupational Therapist | 4100 S Ferdon Blvd, Crestview, FL 32536-5252 | 2012-09-27 |
| 1710271374 | Triple E Ot Inc | Occupational Therapist | 4100 S Ferdon Blvd, Suite C1, Crestview, FL 32536-5252 | 2011-06-01 |
| 1588958276 | Tonie Lyn Allen | Occupational Therapist | 4100 S Ferdon Blvd, Suite C1, Crestview, FL 32536-5252 | 2011-05-31 |
| 1013213057 | Jessica Ann Gibson | Advanced Practice Midwife | 4100 S Ferdon Blvd, Suite A4, Crestview, FL 32536-5252 | 2011-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831684901 | Eva Maria I Matute | Adult Companion | 6050 Trestle St, Crestview, FL 32536 | 2018-06-29 |
| 1669989232 | Lauren Estep Flowers | Physician Assistant | 550 Redstone Ave W Ste 370, Crestview, FL 32536 | 2018-01-04 |
| 1427444868 | Jessie Huisken | Social Worker | 5890 Saratoga Dr, Crestview, FL 32536 | 2015-04-13 |
| 1679846166 | John D. Carlson Md | Specialist | 492 North Wilson Street, Crestview, FL 32536 | 2012-02-15 |
| 1154609691 | Alternative Living, Inc. | Assisted Living Facility | 603 North Pearl Street, Crestview, FL 32536 | 2011-08-02 |
| 1487821526 | Michael G Foley Md Pa | Internal Medicine | 524 James Lee Blvd W, Crestview, FL 32536 | 2008-05-08 |
| 1184805830 | Advanced Family Medicine Clinic Inc | Family Medicine | 327 Medcrest Drive, Unit A, Crestview, FL 32536 | 2007-11-23 |
| 1164631511 | Caring Hearts Pediatric Extended Care Center, Inc | Clinic/Center | 380 Medcrest Dr, Crestview, FL 32536 | 2007-05-22 |
| 1669697751 | Crestview Chiropractic Clinic, Inc. | Chiropractor | 1078 S. Ferdon Boulevard, Suite A, Crestview, FL 32536 | 2007-04-16 |
| 1457492886 | Roy M Nakaiye | Dentist | 222 Cedar Ave, Crestview, FL 32536 | 2007-02-09 |
| Find all providers in zip 32536 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598363327 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 7050 Coral Way, Miami, FL 33155-1603 | 2020-10-14 |
| 1508464348 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 7005 N Davis Hwy, Pensacola, FL 32504-6339 | 2020-10-14 |
| 1013515006 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 620 Riverside Dr, Coral Springs, FL 33071-7615 | 2020-10-13 |
| 1841898822 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1800 Dunlawton Ave, Port Orange, FL 32127-2921 | 2020-10-13 |
| 1689272817 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 16200 Sw 88th St, Miami, FL 33196-4941 | 2020-10-10 |
| 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 |
| 1891392478 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 650 Se 8th St, Homestead, FL 33030-7405 | 2020-10-06 |
| 1316554561 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1100 W Osceola Pkwy, Kissimmee, FL 34741-7515 | 2020-09-30 |
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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.