Individual provider Active NPI

Selenne Rubi Garnelo

  • Optician
  • Zephyrhills, FL
National Provider Identifier
1083026835
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO 5580 Issued in ZZ
Practice address
7400 Gall Blvd
Zephyrhills, FL 33541-4371
Phone
(813) 782-4546
Fax
(813) 782-1902
NPI assigned
May 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO 5580 ZZ Primary

Addresses

Primary practice location

7400 Gall Blvd
Zephyrhills, FL 33541-4371

Mailing address

4399 35TH St N
St Petersburg, FL 33714-3722
Phone (727) 526-0501

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DO 5580ZZMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1083026835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4399 35TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143722",
            "telephone_number": "727-526-0501",
            "fax_number": "727-522-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 GALL BLVD",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335414371",
            "telephone_number": "813-782-4546",
            "fax_number": "813-782-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNELO",
        "first_name": "SELENNE",
        "middle_name": "RUBI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "ZZ",
            "license": "DO 5580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.