Active NPI
Johnny Miracola, DO
- Optician
- Pembroke Pines, FL
National Provider Identifier
1396449070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO6492
- Practice address
- 255 N University Dr
Pembroke Pines, FL 33024-6715 - Phone
- (954) 987-2421
- Fax
- (954) 987-1398
- NPI assigned
- Mar 28, 2023
- Sex
- Male
- 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 | DO6492 | FL | Primary |
Addresses
Primary practice location
255 N University Dr
Pembroke Pines, FL 33024-6715
Mailing address
255 N University Dr
Pembroke Pines, FL 33024-6715
Phone (954) 987-2421
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO6492 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679961600000",
"number": "1396449070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 N UNIVERSITY DR",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330246715",
"telephone_number": "954-987-2421",
"fax_number": "954-987-1398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 N UNIVERSITY DR",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330246715",
"telephone_number": "954-987-2421",
"fax_number": "954-987-1398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRACOLA",
"first_name": "JOHNNY",
"name_prefix": "Mr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-28",
"last_updated": "2023-03-28",
"certification_date": "2023-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO6492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.