Active NPI
Robert D Holmstrom, MD
- Ophthalmology Physician
- Vero Beach, FL
National Provider Identifier
1295969566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME11174
- Practice address
- 4675 28TH CT
Vero Beach, FL 32967-1329 - Phone
- (772) 770-5151
- Fax
- (772) 770-5166
- NPI assigned
- May 14, 2009
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | ME11174 | FL | Primary |
Addresses
Primary practice location
4675 28TH CT
Vero Beach, FL 32967-1329
Mailing address
4675 28TH CT
Vero Beach, FL 32967-1329
Phone (772) 770-5151
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME11174 | FL | MD | Ophthalmology Physician |
| 11174 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242259200000",
"number": "1295969566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4675 28TH CT",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329671329",
"telephone_number": "772-770-5151",
"fax_number": "772-770-5166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4675 28TH CT",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329671329",
"telephone_number": "772-770-5151",
"fax_number": "772-770-5166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMSTROM",
"first_name": "ROBERT",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-14",
"last_updated": "2009-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME11174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.