Active NPI
Nadine Beth Maki, O.D.
- Optometrist
- Fort Myers, FL
National Provider Identifier
1114064326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC 2925
- Practice address
- 10000 Gulf Center Drive
Next to Target Optical
Fort Myers, FL 33913 - Phone
- (239) 415-1010
- NPI assigned
- Jan 30, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC 2925 | FL | Primary |
| Optometrist | 152W00000X | 2541 | MN |
Addresses
Primary practice location
10000 Gulf Center Drive
Next to Target Optical
Fort Myers, FL 33913
Mailing address
7737 Victoria Cove CT
Fort Myers, FL 33908-7217
Phone (239) 415-1010
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
| License | State | Type | Specialty |
|---|---|---|---|
| OPC 2925 | FL | MD | Optometrist |
| 2541 | MN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114064326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7737 VICTORIA COVE CT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339087217",
"telephone_number": "239-415-1010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 GULF CENTER DRIVE",
"address_2": "NEXT TO TARGET OPTICAL",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33913",
"telephone_number": "239-415-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKI",
"first_name": "NADINE",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC 2925",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "2541",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.