{
"Npi": {
"NPI": "1477452258",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ISLAND EYEWEAR AND CONTACT LENSES LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13506 SUMMERPORT VILLAGE PKWY # 254",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WINDERMERE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34786-7366",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-297-6940",
"MailingAddressFaxNumber": "954-448-7021",
"FirstLinePracticeLocationAddress": "6268 W SAMPLE RD STE 406",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CORAL SPRINGS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33067-3272",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-344-9701",
"PracticeLocationAddressFaxNumber": "954-448-7021",
"EnumerationDate": "11/05/2026",
"LastUpdateDate": "11/05/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HENRY",
"AuthorizedOfficialFirstName": "NOEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "954-288-3032",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}