Yanislav Shor, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO5936 Issued in FL

Practice address

3745 NE 163Rd St
North Miami Beach, FL 33160-4104

Phone

(305) 940-0200

Fax

(305) 944-0222

NPI assigned

Feb 6, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1346664679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331604104",
            "telephone_number": "305-940-0200",
            "fax_number": "305-944-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331604104",
            "telephone_number": "305-940-0200",
            "fax_number": "305-944-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOR",
        "first_name": "YANISLAV",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-06",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO5936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.