David Divincenzo, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO2467 Issued in FL

Practice address

3800 S Tamiami TRL # 103
Sarasota, FL 34239-6908

Phone

(941) 365-1633

Fax

(941) 365-1583

NPI assigned

Sep 6, 2016

Last updated

Sep 6, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1396292595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S TAMIAMI TRL # 103",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342396908",
            "telephone_number": "941-365-1633",
            "fax_number": "941-365-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S TAMIAMI TRL # 103",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342396908",
            "telephone_number": "941-365-1633",
            "fax_number": "941-365-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINCENZO",
        "first_name": "DAVID",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO2467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• District Therapy, PLLC
• Michael Anthony Ditaranto, MD
• Taylor Ditchfield, H.I.S
• Xueqing Wang Dittrich
• Rosa Divieste
• John Divito, P.A.
• Sarah Matilda Dixon-Bowdell, PMHNP-BC
• Carolyn Mignin Dixon, M.D.
• Eloise G Dixon, NRCMA
• Tatjana Djukic, APNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.