Organization Active NPI

Roy Z Braunstein MD PA

  • Ophthalmology Physician
  • Lake Wales, FL
National Provider Identifier
1487643649
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0042087 Issued in FL
Legal business name
ROY Z BRAUNSTEIN MD PA
Practice address
749 State Road 60 E
Lake Wales, FL 33853-4240
Phone
(863) 676-7624
Fax
(863) 678-0263
NPI assigned
Oct 19, 2005
Last updated
Oct 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Roy Z Braunstein, MDNPI 1235328444
Title
Owner
Phone
(863) 676-7624

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME0042087 FL Primary

Addresses

Primary practice location

749 State Road 60 E
Lake Wales, FL 33853-4240

Mailing address

749 State Road 60 E
Lake Wales, FL 33853-4240
Phone (863) 676-7624

Other identifiers 1

IdentifierTypeStateIssuer
CN3581OtherFLRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1487643649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534240",
            "telephone_number": "863-676-7624",
            "fax_number": "863-678-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534240",
            "telephone_number": "863-676-7624",
            "fax_number": "863-678-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY Z BRAUNSTEIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "BRAUNSTEIN",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-676-7624",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0042087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN3581",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.