Marquitta Elliott, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO6965 Issued in FL

Practice address

151 SW 184TH Ave
Pembroke Pines, FL 33029-5465

Phone

(954) 442-4182

Fax

(954) 442-6524

NPI assigned

May 23, 2023

Last updated

May 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1164114617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 NW 16TH ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333134708",
            "telephone_number": "954-708-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SW 184TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330295465",
            "telephone_number": "954-442-4182",
            "fax_number": "954-442-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "MARQUITTA",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO6965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.