Juan a Menjivar OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4351 Issued in FL

Legal business name

JUAN A MENJIVAR OD PA

Practice address

180 S Knowles Ave
Winter Park, FL 32789-7009

Phone

(407) 629-2020

NPI assigned

Aug 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Juan A Menjivar, O.D.

Title

President

Phone

(281) 630-6052

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1265665079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 SE 8TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714057",
            "telephone_number": "281-630-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S KNOWLES AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327897009",
            "telephone_number": "407-629-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN A MENJIVAR OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "MENJIVAR",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-630-6052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.