Organization Active NPI

Laura Falco, O.D. LLC

  • Optometrist
  • Davie, FL
National Provider Identifier
1033684410
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LAURA FALCO, O.D. LLC
Practice address
2279 S University Dr
Davie, FL 33324-5828
Phone
(954) 473-0100
Fax
(954) 474-7832
NPI assigned
Oct 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Authorized official

Name
Dr. Laura Angela Falco, ODNPI 1396819132
Title
Owner
Phone
(954) 473-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2279 S University Dr
Davie, FL 33324-5828

Mailing address

2279 S University Dr
Davie, FL 33324-5828
Phone (954) 473-0100

Other identifiers 1

IdentifierTypeStateIssuer
620566600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190619001785 FL Part B Supplier - Clinic/Group Practice 1153655527 Receives reassigned benefits from 2 practitioners
Practice locations: Davie, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1033684410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333245828",
            "telephone_number": "954-473-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333245828",
            "telephone_number": "954-473-0100",
            "fax_number": "954-474-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA FALCO, O.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "FALCO",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-473-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620566600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.