Healthcare Provider Details

I. General information

NPI: 1700949104
Provider Name (Legal Business Name): CENTRAL FLORIDA PREMIER EYE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N US HIGHWAY 441 STE 521
THE VILLAGES FL
32159-8983
US

IV. Provider business mailing address

PO BOX 919799
ORLANDO FL
32891-9799
US

V. Phone/Fax

Practice location:
  • Phone: 352-750-2020
  • Fax:
Mailing address:
  • Phone: 888-856-1878
  • Fax: 941-488-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOT CORBIN HOLMAN
Title or Position: PRESIDENT
Credential:
Phone: 352-343-2020