CABANA EYES OPTICAL NPI 1154867554

Eyewear Supplier in Crestview, FL

NPI 1154867554 Organization Eyewear Supplier

About CABANA EYES OPTICAL

Cabana Eyes Optical is a provider established in Crestview, Florida specializing in eyewear supplier. The NPI number of Cabana Eyes Optical is 1154867554 and was assigned on January 2017. The practitioner's primary taxonomy code is 332H00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Mr. Edward Mitchell Jr. Ldo (Owner/ Visual Resource Director)

NPI

1154867554

Provider NameCABANA EYES OPTICAL
Provider Location Address4100 S FERDON BLVD SUITE B5 CRESTVIEW, FL 32536
Provider Mailing Address4100 S FERDON BLVD SUITE B5 CRESTVIEW, FL 32536
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date01-10-2017
Last Update Date10-23-2019


Primary Taxonomy

Taxonomy Code332H00000X
ClassificationEyewear Supplier
TypeSuppliers
Taxonomy DescriptionAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Business Address

CABANA EYES OPTICAL
4100 S FERDON BLVD
SUITE B5
CRESTVIEW, FL
ZIP 32536
Phone: (850) 758-0474
Fax: (850) 826-0057

Get Directions


Mailing Address

CABANA EYES OPTICAL
4100 S FERDON BLVD
SUITE B5
CRESTVIEW, FL
ZIP 32536
Phone: (850) 306-2580
Fax: (850) 423-0142



Authorized Official

Authorized Official NameMR. EDWARD MITCHELL JR. LDO
Authorized Official TitleOWNER/ VISUAL RESOURCE DIRECTOR
Authorized Official Phone(850) 758-0474

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyNo

Taxonomy Description: an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
003088900MEDICAID (05)FL

Other Providers at the same location


The following 19 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1477503829MRS. SABRA LYNN ARZAGA PT
Individual
Physical Therapist4100 S FERDON BLVD STE C1
CRESTVIEW, FL 32536
(850) 682-8388
1639104425DR. SERGIO J CABRERA MD
Individual
Obstetrics & Gynecology4100 S FERDON BLVD SUITE A4
CRESTVIEW, FL 32536
(850) 398-8940
1245438704 CHARLES SEDILLO MATA CO
Individual
Specialist4100 S FERDON BLVD B-4
CRESTVIEW, FL 32536
(850) 449-0380
1477739829MICHELLE H STEVENS MD PA
Organization
Family Medicine4100 S FERDON BLVD STE C5
CRESTVIEW, FL 32536
(850) 902-1282
1912142415MRS. NANCY DIANE YOHE SPARAGOWSKI
Individual
Occupational Therapy Assistant4100 S FERDON BLVD SUITE C-1
CRESTVIEW, FL 32536
(850) 682-8388
1285879783MRS. STACY MARIE TAYLOR
Individual
Occupational Therapist4100 S FERDON BLVD SUITE C-1
CRESTVIEW, FL 32536
(850) 682-8388
1629378344SERGIO J CABRERA PL LLC
Organization
Obstetrics & Gynecology4100 S FERDON BLVD SUITE A4
CRESTVIEW, FL 32536
(850) 398-8940
1013213057MRS. JESSICA ANN GIBSON MSN, CNM, ARNP
Individual
Advanced Practice Midwife4100 S FERDON BLVD SUITE A4
CRESTVIEW, FL 32536
(850) 398-8940
1710271374TRIPLE E OT INC
Organization
Occupational Therapist (Pediatrics)4100 S FERDON BLVD SUITE C1
CRESTVIEW, FL 32536
(850) 682-8388
1770834988 COURTNEY CELESTE MILLER OTR/L
Individual
Occupational Therapist4100 S FERDON BLVD
CRESTVIEW, FL 32536
(850) 682-8388
1750495149DR. MARIELSA ADRIANZA ADRIANZA-WEIDANZ DDS
Individual
Dentist (General Practice)4100 S FERDON BLVD SUITE C2
CRESTVIEW, FL 32536
(850) 423-4603
1316996713PRIME THERAPY INC
Organization
Physical Therapist4100 S FERDON BLVD STE A1
CRESTVIEW, FL 32536
(850) 682-8388
1821409228 NIKKI LEIGH JUSTICE MS, CFY-SLP
Individual
Speech-Language Pathologist4100 S FERDON BLVD SUITE C1
CRESTVIEW, FL 32536
(850) 682-8388
1184013385 ALLISON RIVERS
Individual
Speech-Language Pathologist4100 S FERDON BLVD
CRESTVIEW, FL 32536
(850) 682-8388
1396396495 DESIRAY LAVON GREER
Individual
Behavior Technician4100 S FERDON BLVD
CRESTVIEW, FL 32536
(850) 362-6824
1538710108 AUBREE A DAVIS
Individual
Behavior Technician4100 S FERDON BLVD
CRESTVIEW, FL 32536
(850) 362-6824
1114559465 JORDAN TAYLOR
Individual
Behavior Technician4100 S FERDON BLVD
CRESTVIEW, FL 32536
(850) 362-6824
1588958276 TONIE LYN PEASLEY OTR/L
Individual
Occupational Therapist4100 S FERDON BLVD SUITE C1
CRESTVIEW, FL 32536
(850) 682-8388
1528636743 NUITE D SHERMAN
Individual
Behavior Technician4100 S FERDON BLVD
CRESTVIEW, FL 32536
(850) 830-2671

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.