Individual provider Active NPI

Balmary Vazquez, O.D.

  • Optometrist
  • Hialeah, FL
National Provider Identifier
1124270905
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4392 Issued in FL
Practice address
1770 W 32ND PL
Hialeah, FL 33012
Phone
(305) 885-4477
NPI assigned
Oct 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001795 VA
Optometrist 152W00000X OPC 4392 FL Primary

Addresses

Primary practice location

1770 W 32ND PL
Hialeah, FL 33012

Mailing address

3464 W 100TH Ter
Hialeah, FL 33018-2103

Other practice location 1

8888 SW 136th St Ste 391
Miami, FL 33176-5801
Phone (305) 232-3141

Other identifiers 1

IdentifierTypeStateIssuer
A00732OtherFLEYEMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190501000737 FL Practitioner - Optometry 4587906177 Reassigns benefits to 2 organizations
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4392FLMDOptometrist
0618001795VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Vision Care Inc Optometrist CurrentSince Jul 1, 2019 Accepting new patients
DRS. Cukierman & Gomez, Inc Optometrist Current Accepting new patients

Locations

2873 Stirling Rd
Ft Lauderdale, FL 33312
Phone (954) 983-4969

1770 W 32nd Pl
Hialeah, FL 33012
Phone (305) 885-4477

3682 W Oakland Park Blvd
Lauderdale Lakes, FL 33311
Phone (954) 730-8087

246 S Flamingo Rd
Pembroke Pines, FL 33027
Phone (954) 442-4602

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1124270905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3464 W 100TH TER",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330182103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 W 32ND PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "33012",
            "telephone_number": "305-885-4477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8888 SW 136th St Ste 391",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331765801",
            "country_code": "US",
            "telephone_number": "305-232-3141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "BALMARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001795",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "A00732",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.