Individual provider Active NPI

Mihai Gitlan, OD

  • Optometrist
  • Sunrise, FL
National Provider Identifier
1316563695
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5806 Issued in FL
Practice address
3004 NW 130TH Ter
Sunrise, FL 33323-3932
Phone
(719) 201-5117
NPI assigned
Jun 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5806 FL Primary

Addresses

Primary practice location

3004 NW 130TH Ter
Sunrise, FL 33323-3932

Mailing address

3004 NW 130TH Ter Apt 438
Sunrise, FL 33323-3951
Phone (719) 201-5117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200729002187 FL Practitioner - Optometry 1153746839 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5806FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Vision Inc Optometrist CurrentSince Mar 4, 2023 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Sep 1, 2020 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Sep 1, 2020 Accepting new patients
Suncoast Eyecare Centers PLLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Luxottica of America Inc PastSince Mar 4, 2023 Accepting new patients

Locations

2416 W Brandon Blvd
Brandon, FL 33511
Phone (813) 684-7070

1929 W Brandon Blvd
Brandon, FL 33511
Phone (813) 684-7071

307 Brandon Town Center Mall
Brandon, FL 33511
Phone (813) 684-0815

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1316563695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 NW 130TH TER APT 438",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233951",
            "telephone_number": "719-201-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 NW 130TH TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233932",
            "telephone_number": "719-201-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITLAN",
        "first_name": "MIHAI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.