Bobby Sarivannara, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4488 Issued in FL

Practice address

325TH Medical Group
340 Magnolia Cir BLDG 1465
Tyndall Afb, FL 32403-5604

Phone

(850) 283-7108

NPI assigned

Aug 27, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• National Vision, Inc.

  • Eyewear Supplier
  • Altamonte Springs, FL
  • NPI 1023164886
  NPD (past)
• National Vision, Inc.

  • Eyewear Supplier
  • Fort Meyers, FL
  • NPI 1477607521
  NPD (past)

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1063645828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325TH MEDICAL GROUP",
            "address_2": "340 MAGNOLIA CIR BLDG 1465",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325TH MEDICAL GROUP",
            "address_2": "340 MAGNOLIA CIR BLDG 1465",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARIVANNARA",
        "first_name": "BOBBY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4488",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4488",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clairissa Richardson, DSW, LCSW
• Lakisha G Roe, PHARMD
• Mary Grace Rojas, PHARMD
• Rachel J Runswick, LCSW
• Omer S Sanabria, DDS
• Jennifer Olivia Simmons, D.D.S.
• James Edward Smith, MSW, LCSW, QS
• Melissa Brooks Smith, LCSW
• Michael R Staklinski, DPT
• Adam Charles Starbuck, DO

• Optometrist in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.