NPIMap

Organization Active NPI

20 20 Optical Dispensatory, Inc.

  • Eyewear Supplier
  • Plantation, FL
National Provider Identifier
1093010696
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
1171 Issued in FL
Legal business name
20 20 OPTICAL DISPENSATORY, INC.
Practice address
1767 N University Dr
Plantation, FL 33322-4111
Phone
(954) 472-2422
NPI assigned
Jan 13, 2011
Last updated
Sep 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Mr. Guilherme William Dwin, DO
Title
Dispensing Optician
Phone
(954) 472-2422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 1171 FL Primary

Addresses

Primary practice location

1767 N University Dr
Plantation, FL 33322-4111

Mailing address

1767 N University Dr
Plantation, FL 33322-4111
Phone (954) 472-2422

Other identifiers 1

IdentifierTypeStateIssuer
GCG459EPMedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1093010696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1767 N UNIVERSITY DR",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333224111",
            "telephone_number": "954-472-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 N UNIVERSITY DR",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333224111",
            "telephone_number": "954-472-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20 20 OPTICAL DISPENSATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "DWIN",
        "authorized_official_first_name": "GUILHERME WILLIAM",
        "authorized_official_title_or_position": "DISPENSING OPTICIAN",
        "authorized_official_telephone_number": "954-472-2422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "1171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GCG459EP",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.