Organization Active NPI

Perez Eye Center P L

  • Ophthalmology Physician
  • Tampa, FL
National Provider Identifier
1194005249
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PEREZ EYE CENTER P L
Practice address
4506 Wishart PL
Tampa, FL 33603-2724
Phone
(813) 875-6588
Fax
(813) 873-3688
NPI assigned
Aug 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Authorized official

Name
Ms. Margarita Whidden
Title
Administrator
Phone
(813) 875-6588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4506 Wishart PL
Tampa, FL 33603-2724

Mailing address

4506 Wishart PL
Tampa, FL 33603-2724
Phone (813) 875-6588

Other identifiers 1

IdentifierTypeStateIssuer
004091300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120314000395 FL Part B Supplier - Clinic/Group Practice 9739348509 Receives reassigned benefits from 2 practitioners
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1194005249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4506 WISHART PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032724",
            "telephone_number": "813-875-6588",
            "fax_number": "813-873-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4506 WISHART PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032724",
            "telephone_number": "813-875-6588",
            "fax_number": "813-873-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEREZ EYE CENTER P L",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "WHIDDEN",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-875-6588",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004091300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.