# FORT WALTON BEACH VISION CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The VIsion Hub at Fort Walton Beach
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225706112
- **Authorized official:** KIMBERLY ANN SAMPSON (INSURANCE/CREDENTIALING COORDINATOR)
- **Authorized official phone:** (850) 206-1133

## Contact information

- **Practice address:** 36 EGLIN PKWY NE, FORT WALTON BEACH, FL 32548-4915
- **Practice address phone:** (850) 243-3111
- **Mailing address:** 36 EGLIN PKWY NE, FORT WALTON BEACH, FL 32548-4915
- **Mailing address phone:** (850) 243-3111
- **Mailing address fax:** (850) 200-4373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2021
- **Last updated:** 05/28/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 112470900 | — | FL |
| 01 | — | WVMGV | FLORIDA BLUE | FL |