Individual provider Active NPI

Elizabeth Mary Howard, DO4553

  • Optician
  • Port Orange, FL
National Provider Identifier
1346848249
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO4553 Issued in FL
Practice address
1633 Taylor Rd Unit 104
Port Orange, FL 32128-6754
Phone
(386) 256-3510
Fax
(386) 265-1969
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO4553 FL Primary

Addresses

Primary practice location

1633 Taylor Rd Unit 104
Port Orange, FL 32128-6754

Mailing address

1633 Taylor Rd Unit 104
Port Orange, FL 32128-6754
Phone (386) 256-3510

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
DO4553FLMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jason Iannarelli P.a. CurrentSince Oct 19, 2020 Accepting new patients

Locations

1633 Taylor Rd
Unit 104
Port Orange, FL 32128
Phone (386) 256-3510

Organizations & group practices 1

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": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1346848249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 TAYLOR RD UNIT 104",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286754",
            "telephone_number": "386-256-3510",
            "fax_number": "386-265-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 TAYLOR RD UNIT 104",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286754",
            "telephone_number": "386-256-3510",
            "fax_number": "386-265-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "credential": "DO4553",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO4553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.