NPIMap

Organization Active NPI

Robert a. Davis OD PA

Doing business as The Eye Center

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1205893658
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC946 Issued in FL
Legal business name
ROBERT A. DAVIS OD PA
Doing business as
The Eye Center
Practice address
1732 N University Dr
Pembroke Pines, FL 33024-3602
Phone
(954) 432-7711
Fax
(954) 432-8017
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Authorized official

Name
Dr. Robert A. Davis, O.D.NPI 1932234523
Title
Optometrist
Phone
(954) 432-7711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC946 FL Primary

Addresses

Primary practice location

1732 N University Dr
Pembroke Pines, FL 33024-3602

Mailing address

1732 N University Dr
Pembroke Pines, FL 33024-3602
Phone (954) 432-7711

Other identifiers 2

IdentifierTypeStateIssuer
620776600MedicaidFL
45914OtherFLBLUE CROSS/BLUE SHIELD

Other names 1

  • The Eye Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050813000009 FL Part B Supplier - Clinic/Group Practice 4082644752 Receives reassigned benefits from 6 practitioners
Practice locations: Pembroke Pines, FL

National Provider Directory

National Provider Directory

Locations

1732 N University Dr
Pembroke Pines, FL 33024
Phone (954) 432-7711

Practitioners & affiliated clinicians

Practitioners 7

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": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1205893658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243602",
            "telephone_number": "954-432-7711",
            "fax_number": "954-432-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243602",
            "telephone_number": "954-432-7711",
            "fax_number": "954-432-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A. DAVIS OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "954-432-7711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620776600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "45914",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.