Dr R Keith Amiel-Optometrist P a

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC874 Issued in FL

Legal business name

DR R KEITH AMIEL-OPTOMETRIST P A

Doing business as

Amiel Eyecare Center

Practice address

36 Eglin Pkwy NE
Fort Walton Beach, FL 32548-4915

Phone

(850) 243-3111

Fax

(850) 200-4373

NPI assigned

Aug 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. R. Keith Amiel, -OPTOMETRIST P A

Title

Owner-President

Phone

(850) 243-3111

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Amiel Eyecare Center Doing business as

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286755200000",
    "number": "1043526205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 EGLIN PKWY NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484915",
            "telephone_number": "850-243-3111",
            "fax_number": "850-200-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 EGLIN PKWY NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484915",
            "telephone_number": "850-243-3111",
            "fax_number": "850-200-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR R KEITH AMIEL-OPTOMETRIST P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-10-11",
        "status": "A",
        "authorized_official_last_name": "AMIEL",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "850-243-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "-OPTOMETRIST P A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19461",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078299300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amiel Eyecare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2010; 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.