Active NPI
Michal Korneev
- Optician
- Fort Lauderdale, FL
National Provider Identifier
1114781218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO7947
- Practice address
- 3346 Griffin Rd
Fort Lauderdale, FL 33312-5519 - Phone
- (754) 280-1144
- NPI assigned
- Feb 8, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contact Lens Fitter | 156FC0801X | DO7947 | FL | |
| Optician | 156FX1800X | DO7947 | FL | Primary |
Addresses
Primary practice location
3346 Griffin Rd
Fort Lauderdale, FL 33312-5519
Mailing address
3346 Griffin Rd
Fort Lauderdale, FL 33312-5519
Phone (754) 280-1144
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 |
|---|---|---|---|
| DO7947 | FL | MD | Contact Lens Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1114781218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3346 GRIFFIN RD",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333125519",
"telephone_number": "754-280-1144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3346 GRIFFIN RD",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333125519",
"telephone_number": "754-280-1144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORNEEV",
"first_name": "MICHAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-08",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FC0801X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Contact Lens Fitter",
"state": "FL",
"license": "DO7947",
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO7947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.