Organization Active NPI

West Broward Eyecare Associates Inc

  • Optometrist
  • Tamarac, FL
National Provider Identifier
1386832244
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0001743 Issued in FL
Legal business name
WEST BROWARD EYECARE ASSOCIATES INC
Practice address
7822 N University Dr
Tamarac, FL 33321-2114
Phone
(954) 726-0204
Fax
(954) 721-1578
NPI assigned
Oct 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Authorized official

Name
Dr. Gustavo Garmizo, ODNPI 1154339000
Title
President
Phone
(954) 726-0204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0001743 FL Primary

Addresses

Primary practice location

7822 N University Dr
Tamarac, FL 33321-2114

Mailing address

7822 N University Dr
Tamarac, FL 33321-2114
Phone (954) 726-0204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930041918 FL DME Supplier - Physician - OptometristDME Supplier - Optician 3072632306 Practice locations: Tamarac, FL
O20110603000499 FL Part B Supplier - Clinic/Group Practice 3072632306 Receives reassigned benefits from 4 practitioners
Practice locations: Tamarac, FL

National Provider Directory

National Provider Directory

Locations

16950 S Jog Rd
Delray Beach, FL 33446
Phone (561) 499-2055

7822 N University Dr
Tamarac, FL 33321
Phone (954) 726-0204

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307059200000",
    "number": "1386832244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7822 N UNIVERSITY DR",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212114",
            "telephone_number": "954-726-0204",
            "fax_number": "954-721-1578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7822 N UNIVERSITY DR",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212114",
            "telephone_number": "954-726-0204",
            "fax_number": "954-721-1578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BROWARD EYECARE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2011-06-03",
        "status": "A",
        "authorized_official_last_name": "GARMIZO",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-726-0204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "0001743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.