MEDICARE: PARK AVENUE OPHTHALMICS, PLLC

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

General Provider Information

NPI Number	:	1629272265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARK AVENUE OPHTHALMICS, PLLC

Provider Business Mailing Address
First Line	:	1911 N MILLS AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-1407
Country	:	US
Telephone Number	:	407-893-8200
Fax Number	:	407-893-8220

Provider Business Practice Location Address
First Line	:	2269 E SEMORAN BLVD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-5713
Country	:	US
Telephone Number	:	407-886-2093
Fax Number	:	407-886-9531

Authorized Official
Title or Position	:	CHIEF GROWTH OFFICER
Name	:	CHAD TOMLINSON
Credential	:
Telephone Number	:	407-383-2004

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	04/03/2026

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