Emmanuel Jeoboam

Primary specialty

OpticianTaxonomy code 156FX1800X

License

6534 Issued in FL

Practice address

5555 W Atlantic Blvd
Margate, FL 33063-5296

Phone

(954) 975-7179

Fax

(954) 954-9757

NPI assigned

Nov 25, 2024

Last updated

Nov 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1366268203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 W ATLANTIC BLVD",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330635296",
            "telephone_number": "954-957-7179",
            "fax_number": "954-975-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W ATLANTIC BLVD",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330635296",
            "telephone_number": "954-975-7179",
            "fax_number": "954-954-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEOBOAM",
        "first_name": "EMMANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "6534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Frantz Guillaume (Negro American)
• Rachelle Jean-Louis
• Diana Jean
• Kathleen Lawrence Jeannot, M.D.
• Jeffrey N Weiss MD.PA (retina associates of south florida)
• Jerold a Mills OD PA
• Jerold a. Cohen, M.D., P.a.
• Jerry Perlmutter D P M P a
• Paige Swalley Jeziorski, DO
• JFK Diagnostic, Inc

• Optician in Margate, FL
• Providers in Margate, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.