Organization Active NPI

Richard a. Jablonski, DO PA

  • Ophthalmology Physician
  • Ormond Beach, FL
National Provider Identifier
1275655417
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
OS3838 Issued in FL
Legal business name
RICHARD A. JABLONSKI, DO PA
Practice address
1425 Hand Ave
Suite a
Ormond Beach, FL 32174-1135
Phone
(386) 673-3345
Fax
(386) 672-1854
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Authorized official

Name
Dr. Richard A Jablonski, D.O.
Title
Physician
Phone
(386) 673-3345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X OS3838 FL Primary

Addresses

Primary practice location

1425 Hand Ave
Suite a
Ormond Beach, FL 32174-1135

Mailing address

1425 Hand Ave
Suite a
Ormond Beach, FL 32174-1135
Phone (386) 673-3345

Other identifiers 1

IdentifierTypeStateIssuer
038175600MedicaidFL

Other names 1

  • Ormond Eye Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263513600000",
    "number": "1275655417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 HAND AVE",
            "address_2": "SUITE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741135",
            "telephone_number": "386-673-3345",
            "fax_number": "386-672-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 HAND AVE",
            "address_2": "SUITE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741135",
            "telephone_number": "386-673-3345",
            "fax_number": "386-672-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD A. JABLONSKI, DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2010-01-15",
        "status": "A",
        "authorized_official_last_name": "JABLONSKI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "386-673-3345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "OS3838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038175600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ormond Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.