Organization Active NPI

Alejandro M Tirado OD PA

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1346483302
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2566 Issued in FL
Legal business name
ALEJANDRO M TIRADO OD PA
Practice address
1524 3Rd St N
Jacksonville, FL 32250-7352
Phone
(904) 241-3162
Fax
(904) 249-7190
NPI assigned
Apr 7, 2009
Last updated
Feb 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Authorized official

Name
Leslie McNeil
Title
Office Manager
Phone
(904) 241-3162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC2566 FL Primary

Addresses

Primary practice location

1524 3Rd St N
Jacksonville, FL 32250-7352

Mailing address

1524 3Rd St N
Jacksonville, FL 32250-7352
Phone (904) 241-3162

Other identifiers 1

IdentifierTypeStateIssuer
1285700252OtherFLINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

1524 3rd St N
Jacksonville Beach, FL 32250
Phone (904) 241-3162

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1346483302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 3RD ST N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322507352",
            "telephone_number": "904-241-3162",
            "fax_number": "904-249-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 3RD ST N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322507352",
            "telephone_number": "904-241-3162",
            "fax_number": "904-249-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEJANDRO M TIRADO OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "MCNEIL",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-241-3162"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1285700252",
            "state": "FL"
        }
    ],
    "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 Feb 16, 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.