Marc Jay Gannon Optometrist PA

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

OPC1271 Issued in FL

Legal business name

MARC JAY GANNON OPTOMETRIST PA

Practice address

2021 E Commercial Blvd
301
Fort Lauderdale, FL 33308-3763

Phone

(954) 776-5223

Fax

(954) 491-0027

NPI assigned

Sep 18, 2008

Last updated

Aug 4, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marc Jay Gannon, O.D.NPI 1841286424

Title

Director

Phone

(954) 776-5223

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marc Jay Gannon, O.D.

  • Low Vision Rehabilitation Optometrist
  • Fort Lauderdale, FL
  • NPI 1841286424
  Medicare reassignment NPD Authorized official
• Amanda Amberg, OD

  • Optometrist
  • Tamarac, FL
  • NPI 1053904813
  NPD (past)
• Meir Mosheh Baalhaness, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Deerfield Beach, FL
  • NPI 1114001427
  NPD (past)
• Barbara Barnett, OTR/L

  • Occupational Therapist
  • Plantation, FL
  • NPI 1003057605
  NPD (past)
• Isabel Madolyn Carvajal, OD

  • Optometrist
  • Coral Springs, FL
  • NPI 1437347499
  NPD (past)
• Salvatore De Canio, O.D., F.A.A.O.

  • Corneal and Contact Management Optometrist
  • Naples, FL
  • NPI 1538142302
  NPD (past)
• Claudio A Ferreira, MD

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1548207426
  NPD (past)
• Stephanie Theresa Frankel, O.D.

  • Optometrist
  • Miami, FL
  • NPI 1184058174
  NPD (past)
• Pooja Garg, M.D.

  • Ophthalmology Physician
  • Coconut Creek, FL
  • NPI 1932496346
  NPD (past)
• Gustavo Garmizo, OD

  • Optometrist
  • Tamarac, FL
  • NPI 1154339000
  NPD (past)
• Shareen M Greenbaum, MD

  • Ophthalmology Physician
  • Hollywood, FL
  • NPI 1912039363
  NPD (past)
• Shailesh K Gupta, MD

  • Retina Specialist (Ophthalmology) Physician
  • Deerfield Beach, FL
  • NPI 1467424382
  NPD (past)

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249344000000",
    "number": "1194974782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083763",
            "telephone_number": "954-776-5223",
            "fax_number": "954-491-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "301",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083763",
            "telephone_number": "954-776-5223",
            "fax_number": "954-491-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC JAY GANNON OPTOMETRIST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2009-08-04",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-776-5223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "FL",
            "license": "OPC1271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078390100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marathon Health, LLC
• Philip Ralph Marcadis
• Claudia Beatriz Marcano, MD
• Raquel Marcano
• Marcela D Murcia DMD PA
• Marcelle Abell-Rosen MD PA

• Low Vision Rehabilitation Optometrist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Low Vision Rehabilitation Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.