Organization
EYESUPPLY
Active
Other names
2020 EYEGLASS SUPERSTORE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD UCCI ABOC NCLE (GENERAL MANAGER)
(321) 259-3935
Entity
Organization
Contact information
Practice address
785 N WICKHAM RD, STE. 106, MELBOURNE, FL 32935-8857
(321) 259-3935
Mailing address
785 N WICKHAM RD, STE. 106, MELBOURNE, FL 32935-8857
(321) 259-3935
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC2732
FL
156FC0801X
Contact Lens Fitter
DO3652
FL
156FC0801X
Contact Lens Fitter
DO5119
FL
156FX1800X
Optician
DO3652
FL
156FX1800X
Optician
DO5119
FL
332H00000X
Eyewear Supplier
Primary
OE1487
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29268
SPECTRA
FL
01
—
FL2732
EYEMED
FL
01
—
FL5119
EYEMED
FL
Enumeration date
02/07/2007
Last updated
09/11/2025
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