Optic Planet LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OPTIC PLANET LLC

Practice address

15332 NW 79TH CT
Miami Lakes, FL 33016-5808

Phone

(305) 821-0304

Fax

(305) 558-0641

NPI assigned

Jul 25, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Denise Martin

Title

Biller

Phone

(305) 821-0304

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mauri eye associates Doing business as

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1134800030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15332 NW 79TH CT",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165808",
            "telephone_number": "305-821-0304",
            "fax_number": "305-558-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15332 NW 79TH CT",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165808",
            "telephone_number": "305-821-0304",
            "fax_number": "305-558-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIC PLANET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "305-821-0304",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669133625",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285159178",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811144850",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mauri eye associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Miami Lakes, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.