Individual provider Active NPI

Veronica Marie Carrero, O.D.

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1164688073
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4579 Issued in FL
Practice address
1500 S Hiatus Rd
Pembroke Pines, FL 33025-3617
Phone
(954) 438-4000
Fax
(954) 438-6000
NPI assigned
Jul 30, 2008
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7310TG TX
Optometrist 152W00000X OPC 4579 FL Primary

Addresses

Primary practice location

1500 S Hiatus Rd
Pembroke Pines, FL 33025-3617

Mailing address

1500 S Hiatus Rd
Pembroke Pines, FL 33025-3617
Phone (954) 438-4000

Other practice location 1

4560 W 12th Ave
Hialeah, FL 33012-3325
Phone (305) 828-1989

Other identifiers 1

IdentifierTypeStateIssuer
005480800MedicaidFL

Other names 1

  • Dr. Veronica Marie Hormilla Former name

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
I20130104000390 FL Practitioner - Optometry 0143384420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4579FLMDOptometrist
7310TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Mercedes, LLC CurrentSince Dec 16, 2024 Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Dec 16, 2024 Accepting new patients
Sidney J Stern Visual Health Centers PA Optometrist Past Accepting new patients
South Texas Eye Consultants, PLLC Past Accepting new patients

Locations

11735 SW 147th Ave
Unit 16
Miami, FL 33196
Phone (786) 953-8200

1479 NW 27th Ave
Miami, FL 33125
Phone (305) 633-3776

6355 NW 36th St
Ste 1100
Virginia Gardens, FL 33166

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1164688073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S HIATUS RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330253617",
            "telephone_number": "954-438-4000",
            "fax_number": "954-438-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S HIATUS RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330253617",
            "telephone_number": "954-438-4000",
            "fax_number": "954-438-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4560 W 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330123325",
            "country_code": "US",
            "telephone_number": "305-828-1989",
            "fax_number": "305-826-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRERO",
        "first_name": "VERONICA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7310TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005480800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERONICA",
            "last_name": "HORMILLA",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.