Pelican Plaza Optical

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

3259 Issued in FL

Legal business name

PELICAN PLAZA OPTICAL

Practice address

8390 S Tamiami TRL
Sarasota, FL 34238-2934

Phone

(941) 966-1559

Fax

(941) 966-1559

NPI assigned

Jan 24, 2008

Last updated

Mar 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Grondahl, D.O.

Title

Optician/Owner

Phone

(941) 966-1559

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1023295763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342382934",
            "telephone_number": "941-966-1559",
            "fax_number": "941-966-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342382934",
            "telephone_number": "941-966-1559",
            "fax_number": "941-966-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN PLAZA OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "GRONDAHL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OPTICIAN/OWNER",
        "authorized_official_telephone_number": "941-966-1559",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "3259",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "3259",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Pedicone, PHARM.D
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• Elzbieta Pelc
• Pellechoud Enterprises
• Martha Pellegrino, RN IBCLC
• Anne Marie Pelletier, CRNA
• Nicholas Christopher Pelletier, PHARMACIST
• Lizbell Pelliccia

• Durable Medical Equipment & Medical Supplies in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.