Active NPI
Deborah J Fantin, DO
- Optician
- Arcadia, FL
National Provider Identifier
1104099944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO 4027
- Practice address
- 14 S Polk Ave
Arcadia, FL 34266-3950 - Phone
- (863) 993-9911
- Fax
- (863) 993-1022
- NPI assigned
- Apr 11, 2008
- Last updated
- Apr 11, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | DO 4027 | FL | Primary |
Addresses
Primary practice location
14 S Polk Ave
Arcadia, FL 34266-3950
Mailing address
14 S Polk Ave
Arcadia, FL 34266-3950
Phone (863) 993-9911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 650942504 | Other | FL | TAX ID |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO 4027 | FL | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arcadia Eyewear Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Eyewear Supplier
- Arcadia, FL
- NPI 1558536466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207872000000",
"number": "1104099944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 S POLK AVE",
"city": "ARCADIA",
"state": "FL",
"postal_code": "342663950",
"telephone_number": "863-993-9911",
"fax_number": "863-993-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 S POLK AVE",
"city": "ARCADIA",
"state": "FL",
"postal_code": "342663950",
"telephone_number": "863-993-9911",
"fax_number": "863-993-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANTIN",
"first_name": "DEBORAH",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-11",
"last_updated": "2008-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO 4027",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "650942504",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, FL
- Erica Escamilla, APRN
- Kyle L Fairchild, ARNP
- Johari Patrice Faison, PMHNP-BC
- Family Care Medical Center II LLC (Family Care Medical Center)
- Family Care Medical Center II LLC (Family Care Medical Center)
- Deanna Lynn Feher, LCSW
- Jessica Alexandra Fennell-Thomas, APRN
- John Fernandez, PT
- Juan Carlos Fernandez, APRN
- Florida Department of Health (DeSoto County Health Department)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.