Individual provider Active NPI

Ronda Rena Morreale, O.D.

  • Optometrist
  • Melbourne, FL
National Provider Identifier
1023185774
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3053 Issued in FL
Practice address
1950 N Wickham Rd
Melbourne, FL 32935-8179
Phone
(321) 752-5454
Fax
(321) 752-5405
NPI assigned
Nov 29, 2006
Last updated
Mar 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3053 FL Primary
Corneal and Contact Management Optometrist 152WC0802X OPC 3053 FL

Addresses

Primary practice location

1950 N Wickham Rd
Melbourne, FL 32935-8179

Mailing address

1950 N Wickham Rd
Melbourne, FL 32935-8179
Phone (321) 752-5454

Other identifiers 1

IdentifierTypeStateIssuer
620353100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3053FLMDCorneal and Contact Management Optometrist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1023185774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358179",
            "telephone_number": "321-752-5454",
            "fax_number": "321-752-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358179",
            "telephone_number": "321-752-5454",
            "fax_number": "321-752-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORREALE",
        "first_name": "RONDA",
        "middle_name": "RENA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3053",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC 3053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620353100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.