| Organization Name: | EYE SITE CENTER, INC. |
| NPI Number: | 1982915922 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK S. LUEDKE (PRES) |
| Mailing Address: | 9433 Balm Riverview Rd Ste 102 Riverview |
| State: | FL US |
| Postal Code: | 335695120 |
| Phone Number: | 8136772995 |
| Fax Number: | 8136775549 |
| NPI Enumeration Date: | 06/24/2010 |
| NPI Last Update Date: | 09/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | OPC2762 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |