Individual provider Active NPI

Viviannette Marie Montalvo Nadal, OD

  • Optometrist
  • Kissimmee, FL
National Provider Identifier
1346805363
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5626 Issued in FL
Practice address
755 W Osceola Pkwy
Kissimmee, FL 34741-7565
Phone
(407) 870-0043
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 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 5626 FL Primary

Addresses

Primary practice location

755 W Osceola Pkwy
Kissimmee, FL 34741-7565

Mailing address

401 Calle Llorens Torres
Floral Park GDNS Apts Apt 6
San Juan, PR 00917-3539
Phone (787) 449-3754

Other practice location 1

401 Calle Llorens Torres
Floral Park GDNS APTS Apt 6
San Juan, PR 00917-3539
Phone (787) 449-3754

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

State licenses

LicenseStateTypeSpecialty
5626FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision, Inc. PastSince Aug 2, 2020 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist PastSince Aug 2, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1346805363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CALLE LLORENS TORRES",
            "address_2": "FLORAL PARK GDNS APTS APT 6",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009173539",
            "telephone_number": "787-449-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 W OSCEOLA PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417565",
            "telephone_number": "407-870-0043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Calle Llorens Torres",
            "address_2": "Floral Park GDNS APTS Apt 6",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009173539",
            "country_code": "US",
            "telephone_number": "787-449-3754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTALVO NADAL",
        "first_name": "VIVIANNETTE",
        "middle_name": "MARIE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.