Healthcare Provider Details

I. General information

NPI: 1578000626
Provider Name (Legal Business Name): OCALA EYE OPTICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 LAUREL MANOR DR STE 250
THE VILLAGES FL
32162-5602
US

IV. Provider business mailing address

4414 SW COLLEGE RD UNIT 1462
OCALA FL
34474-2701
US

V. Phone/Fax

Practice location:
  • Phone: 352-629-7404
  • Fax: 352-622-3834
Mailing address:
  • Phone: 352-622-7404
  • Fax: 352-622-3834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: ZORA HARRISON
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 352-622-5183