Individual provider Active NPI

Carlos Fernandez Perdomo, LDO 7534

  • Optician
  • Hialeah Gardens, FL
National Provider Identifier
1346931888
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO7534 Issued in FL
Practice address
9300 NW 77TH Ave
Hialeah Gardens, FL 33016-2504
Phone
(305) 819-2313
Fax
(305) 819-3546
NPI assigned
May 16, 2023
Last updated
May 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO7534 FL Primary

Addresses

Primary practice location

9300 NW 77TH Ave
Hialeah Gardens, FL 33016-2504

Mailing address

9300 NW 77TH Ave
Hialeah Gardens, FL 33016-2504
Phone (305) 819-2313

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
DO7534FLMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1346931888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 NW 77TH AVE",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330162504",
            "telephone_number": "305-819-2313",
            "fax_number": "305-819-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 NW 77TH AVE",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330162504",
            "telephone_number": "305-819-2313",
            "fax_number": "305-819-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ PERDOMO",
        "first_name": "CARLOS",
        "credential": "LDO 7534",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO7534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.