Active NPI
Miriam Mendivil, O.D
- Optometrist
- Coral Gables, FL
National Provider Identifier
1194962126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC 4038
- Practice address
- 5438 SW 8TH St
Coral Gables, FL 33134-2267 - Phone
- (305) 444-8676
- Fax
- (305) 444-5181
- NPI assigned
- Jan 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC 4038 | FL | Primary |
Addresses
Primary practice location
5438 SW 8TH St
Coral Gables, FL 33134-2267
Mailing address
3180 SW 129TH Ave
Miami, FL 33175-2508
Phone (305) 905-9184
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051115000705 | FL | Practitioner - Optometry | 7416976816 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC 4038 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1194962126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3180 SW 129TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331752508",
"telephone_number": "305-905-9184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5438 SW 8TH ST",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331342267",
"telephone_number": "305-444-8676",
"fax_number": "305-444-5181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDIVIL",
"first_name": "MIRIAM",
"credential": "O.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-13",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC 4038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Gables, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.