Super Optical Express

LBN: Super Optical Express
Super Optical Express is an health care organization with primary practice located at 6757 W Newberry Rd , Gainesville FL 32605-4312. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Super Optical Express can be contacted via phone (352) 331-2040, or through Funderburk, Paul E via phone (352) 331-2040.

Contact Information

Primary practice address
6757 W Newberry Rd Gainesville FL 32605-4312
Phone: (352) 331-2040
Fax: (352) 331-1526
Website:
Map and Directions
Authorized official contact:
Name: Funderburk, Paul E Doctor of Optometry (OD)
Phone: (352) 331-2040

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 796 Florida

Profile Details

NPI number 1639325434
LBN Legal business name Super Optical Express
DBA Doing business as
Authorized official Funderburk, Paul E Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 12th, 2008
Last updated Oct 26th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639325434 NPPES
Florida MEDICAID 084305900
Florida MEDICAID 084871900

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