Active NPI
Laurie Ann Marcionette, LDO
- Optician
- Brooksville, FL
National Provider Identifier
1376020008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO2242
- Practice address
- 13128 Cortez Blvd
Brooksville, FL 34613-4858 - Phone
- (352) 597-0410
- Fax
- (352) 515-0750
- NPI assigned
- Jul 25, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO2242 | FL | Primary |
Addresses
Primary practice location
13128 Cortez Blvd
Brooksville, FL 34613-4858
Mailing address
4359 35TH St N
St Petersburg, FL 33714-3717
Phone (727) 914-8615
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
| License | State | Type | Specialty |
|---|---|---|---|
| DO2242 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532476800000",
"number": "1376020008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4359 35TH ST N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337143717",
"telephone_number": "727-914-8615",
"fax_number": "727-914-8610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13128 CORTEZ BLVD",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346134858",
"telephone_number": "352-597-0410",
"fax_number": "352-515-0750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCIONETTE",
"first_name": "LAURIE",
"middle_name": "ANN",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-25",
"last_updated": "2018-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO2242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooksville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.