MEDICARE: CENTRAL FLORIDA PREMIER EYE ASSOCIATES

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1528121936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL FLORIDA PREMIER EYE ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 919799
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891-9799
Country	:	US
Telephone Number	:	352-343-2020
Fax Number	:	352-343-4728

Provider Business Practice Location Address
First Line	:	601 E DIXIE AVE
Second Line	:	SUITE 201
City	:	LEESBURG
State	:	FL
Zip	:	34748-5953
Country	:	US
Telephone Number	:	352-365-2020
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SCOT CORBIN HOLMAN
Credential	:
Telephone Number	:	352-343-4798

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	05/21/2026

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