Organization Active NPI

Pavel V Gazdovich OD PA

  • Optometrist
  • Miami, FL
National Provider Identifier
1255722401
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4933 Issued in FL
Legal business name
PAVEL V GAZDOVICH OD PA
Practice address
9569 S Dixie Hwy
Miami, FL 33156-2802
Phone
(305) 424-8451
Fax
(305) 424-4248
NPI assigned
Feb 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Pavel V Gazdovich, OD
Title
Optometrist/ Owner
Phone
(305) 424-8451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC4933 FL Primary

Addresses

Primary practice location

9569 S Dixie Hwy
Miami, FL 33156-2802

Mailing address

3260 SW 140TH Ave
Miami, FL 33175-6755
Phone (305) 424-8451

National Provider Directory

National Provider Directory

Locations

10101 W Flagler St
Miami, FL 33174
Phone (305) 227-3380

NPI Registry JSON

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1255722401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 SW 140TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756755",
            "telephone_number": "305-424-8451",
            "fax_number": "305-424-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9569 S DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562802",
            "telephone_number": "305-424-8451",
            "fax_number": "305-424-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVEL V GAZDOVICH OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "GAZDOVICH",
        "authorized_official_first_name": "PAVEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OPTOMETRIST/ OWNER",
        "authorized_official_telephone_number": "305-424-8451",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.