Individual provider Active NPI

Michelle Yvonne Leal, O.D.

  • Optometrist
  • Jupiter, FL
National Provider Identifier
1215050638
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3599 Issued in FL
Practice address
600 Heritage Dr
Suite 120
Jupiter, FL 33458-3000
Phone
(561) 626-9300
Fax
(561) 626-5908
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3599 FL Primary

Addresses

Primary practice location

600 Heritage Dr
Suite 120
Jupiter, FL 33458-3000

Mailing address

600 Heritage Dr
Suite 120
Jupiter, FL 33458-3000
Phone (561) 626-9300

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090723000776 FL Practitioner - Optometry 5395897276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1215050638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HERITAGE DR",
            "address_2": "SUITE 120",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583000",
            "telephone_number": "561-626-9300",
            "fax_number": "561-626-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HERITAGE DR",
            "address_2": "SUITE 120",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583000",
            "telephone_number": "561-626-9300",
            "fax_number": "561-626-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAL",
        "first_name": "MICHELLE",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.