LIFETIME EYECARE CENTER LLC NPI 1619180775

NPI Information

  • NPI: 1619180775
  • Provider Name: LIFETIME EYECARE CENTER LLC
  • Classification: Eyewear Supplier - 332H00000X
  • Entity Type: Organization
  • Other Name: LIFETIME EYECARE
  • CLIA Number: 10D2150863
  • Address: 5455 MURRELL RD
    SUITE 107
    VIERA, FL
    ZIP 32955
  • Phone: (321) 636-1972

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NPI Details

LIFETIME EYECARE CENTER LLC is an eyewear supplier in Viera, FL. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. LIFETIME EYECARE CENTER LLC NPI is 1619180775. The provider is registered as an organization entity type.
The provider Other Name Is Lifetime Eyecare.

The provider's business location address is:

5455 MURRELL RD
SUITE 107
VIERA, FL
ZIP 32955-615
Phone: (321) 636-1972
Fax: (321) 636-1507

The provider's authorized official is Mark Rowell Fisher .
The authorized official title is Optometric Physician and has the following contact phone number (321) 636-1972.

The CLIA number assigned to this NPI record is 10D2150863 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 1/4/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierOPC 1739FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1078956900MEDICAIDFLORIDA
25966100001MEDICARE NSCFLORIDA
3T85231MEDICARE UPIN
419829OTHERFLORIDABCBS OF FL
519829YMEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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