MEDICARE: EYE CARE ASSOCIATES OF CENTRAL FLORIDA, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4399	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285028134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CARE ASSOCIATES OF CENTRAL FLORIDA, P.A.

Provider Business Mailing Address
First Line	:	15508 W COLONIAL DR STE 102
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-9557
Country	:	US
Telephone Number	:	407-798-8880
Fax Number	:	407-798-8810

Provider Business Practice Location Address
First Line	:	15508 W COLONIAL DR STE 102
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-9557
Country	:	US
Telephone Number	:	407-798-8880
Fax Number	:	407-798-8810

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ASHLEY ZAK KIMBLE
Credential	:
Telephone Number	:	954-849-4656

Provider Enumeration Date	:	03/27/2015
Last Update Date	:	02/01/2022

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