Beach Drive Optical

Primary specialty

OpticianTaxonomy code 156FX1800X

License

4546 Issued in FL

Legal business name

BEACH DRIVE OPTICAL

Practice address

238 Beach Dr NE
St Petersburg, FL 33701-3414

Phone

(727) 823-2773

Fax

(727) 823-9039

NPI assigned

Nov 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Karen Simmons, LDO

Title

Manager

Phone

(727) 823-2773

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275609471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 BEACH DR NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013414",
            "telephone_number": "727-823-2773",
            "fax_number": "727-823-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 BEACH DR NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013414",
            "telephone_number": "727-823-2773",
            "fax_number": "727-823-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH DRIVE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "727-823-2773",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "4546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.