Active NPI
Alejandro Miguel Tirado, OD, PA
- Optometrist
- Jacksonville, FL
National Provider Identifier
1285700252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC02566
- Practice address
- 13119 Professional Dr
Suite 100
Jacksonville, FL 32225-6150 - Phone
- (904) 683-8444
- Fax
- (904) 683-5148
- NPI assigned
- Nov 28, 2006
- Last updated
- Sep 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC02566 | FL | Primary |
Addresses
Primary practice location
13119 Professional Dr
Suite 100
Jacksonville, FL 32225-6150
Mailing address
13119 Professional Dr
Suite 100
Jacksonville, FL 32225-6150
Phone (904) 683-8444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC02566 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Vision, Inc. | Past | Accepting new patients | |
| National Vision, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411344000000",
"number": "1285700252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13119 PROFESSIONAL DR",
"address_2": "SUITE 100",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322256150",
"telephone_number": "904-683-8444",
"fax_number": "904-683-5148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13119 PROFESSIONAL DR",
"address_2": "SUITE 100",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322256150",
"telephone_number": "904-683-8444",
"fax_number": "904-683-5148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIRADO",
"first_name": "ALEJANDRO",
"middle_name": "MIGUEL",
"name_prefix": "Dr.",
"credential": "OD, PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2014-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC02566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.