Individual provider Active NPI

Andrew Joseph Ciambrone, OD

  • Optometrist
  • Kissimmee, FL
National Provider Identifier
1487645974
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC003324 Issued in FL
Practice address
4444 W Vine St
Kissimmee, FL 34746-5315
Phone
(407) 390-0585
Fax
(407) 397-9231
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC003324 FL Primary

Addresses

Primary practice location

4444 W Vine St
Kissimmee, FL 34746-5315

Mailing address

3841 Strafford PL
Lakeland, FL 33810-2471
Phone (863) 670-0109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2022 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC003324FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fazio Eye Institute, PA Optometrist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1487645974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 STRAFFORD PL",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338102471",
            "telephone_number": "863-670-0109",
            "fax_number": "407-397-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 W VINE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347465315",
            "telephone_number": "407-390-0585",
            "fax_number": "407-397-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIAMBRONE",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC003324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.