Justin Waller OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JUSTIN WALLER OD PLLC

Doing business as

Advanced Optical

Practice address

2830 N Hiawassee Rd
Orlando, FL 32818-3319

Phone

(863) 529-3119

NPI assigned

Feb 20, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Justin Blaine Waller, ODNPI 1780239640

Title

Owner

Phone

(863) 529-3119

Specialties & licenses 1

Addresses

Other names 1

• Advanced Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justin Blaine Waller, OD

  • Optometrist
  • Orlando, FL
  • NPI 1780239640
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1265238323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 N HIAWASSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183319",
            "telephone_number": "863-529-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 N HIAWASSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183319",
            "telephone_number": "863-529-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN WALLER OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "BLAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-529-3119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Just-US Services, Inc
• Charles Juste, APRN
• Fabiola Juste
• Chloe Justesen
• Kaitlin Sue Justice, ARNP
• Julissa Justiniano Ayala, DDS
• Gina Brigitte Justis, M.D.
• Samantha Justyn, PHARMD
• JV'S Foundation Corp
• JW Medical Group Inc

• Optometrist in Orlando, FL
• Providers in Orlando, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.