Mdoptical

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

MDOPTICAL

Practice address

12981 S Orange Blossom TRL
Orlando, FL 32837-6592

Phone

(407) 816-5958

NPI assigned

Jul 22, 2010

Last updated

Jul 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Juan Alberto Gonzalez

Title

Ceo

Phone

(407) 816-5958

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1417260183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12981 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376592",
            "telephone_number": "407-816-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12981 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376592",
            "telephone_number": "407-816-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDOPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-816-5958",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Orlando, FL
• Providers in Orlando, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.