Active NPI
Johnlee Beaton, OD
- Optometrist
- Tamarac, FL
National Provider Identifier
1104066067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC4378
- Practice address
- 9800 W Commercial Blvd
Tamarac, FL 33351-4325 - Phone
- (954) 475-5500
- NPI assigned
- Mar 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC4378 | FL | Primary |
Addresses
Primary practice location
9800 W Commercial Blvd
Tamarac, FL 33351-4325
Mailing address
3610 S Ocean Blvd Apt 603
South Palm Beach, FL 33480-5877
Phone (305) 310-1842
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC4378 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655078400000",
"number": "1104066067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3610 S OCEAN BLVD APT 603",
"city": "SOUTH PALM BEACH",
"state": "FL",
"postal_code": "334805877",
"telephone_number": "305-310-1842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9800 W COMMERCIAL BLVD",
"city": "TAMARAC",
"state": "FL",
"postal_code": "333514325",
"telephone_number": "954-475-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEATON",
"first_name": "JOHNLEE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-04",
"last_updated": "2022-06-13",
"certification_date": "2022-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC4378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tamarac, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.