Organization
20/20 EYEGLASS SUPERSTORE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD UCCI ABOC NCLE (GENERAL MANAGER)
(407) 767-5600
Entity
Organization
Contact information
Practice address
1555 N. SEMORAN BLVD., SUITE 1221, WINTER PARK, FL 32792
(407) 767-5600
(407) 331-0277
Mailing address
1555 N. SEMORAN BLVD., SUITE 1221, WINTER PARK, FL 32792
(407) 767-5600
(407) 331-0277
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0844
FL
156FC0801X
Contact Lens Fitter
DO 2187
FL
156FC0801X
Contact Lens Fitter
DO 5119
FL
156FX1800X
Optician
DO 2187
FL
156FX1800X
Optician
DO 5119
FL
332H00000X
Eyewear Supplier
OE 874
FL
332H00000X
Eyewear Supplier
Primary
OE874
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10654
SPECTERA
FL
01
—
20186
BLUE CROSS BLUE SHIELD
FL
01
—
FL0844
EYEMED
FL
Enumeration date
02/02/2007
Last updated
08/31/2011
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