Doctor Phan Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3501 Issued in FL

Legal business name

DOCTOR PHAN EYE CARE LLC

Practice address

19501 NW 27TH Ave
Miami Gardens, FL 33056-2521

Phone

(305) 974-2588

NPI assigned

Jan 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Khai G Phan, OD

Title

Owner

Phone

(305) 974-2588

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1184012668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19501 NW 27TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330562521",
            "telephone_number": "305-974-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19501 NW 27TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330562521",
            "telephone_number": "305-974-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR PHAN EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "KHAI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-974-2588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014191100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.