NPIMap

Organization Active NPI

Miami Lakes Eye Care Center PA

  • Ophthalmology Physician
  • Miami Lakes, FL
National Provider Identifier
1497772685
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0047681 Issued in FL
Legal business name
MIAMI LAKES EYE CARE CENTER PA
Practice address
15600 NW 67TH Ave
210
Miami Lakes, FL 33014-2174
Phone
(305) 825-2020
Fax
(305) 556-0557
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Authorized official

Name
Mrs. Barbara Zambrano
Title
Administrator
Phone
(305) 825-2020

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPC002421 FL
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPC004209 FL
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X ME0047462 FL
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X ME0047681 FL Primary

Addresses

Primary practice location

15600 NW 67TH Ave
210
Miami Lakes, FL 33014-2174

Mailing address

15600 NW 67TH Ave
210
Miami Lakes, FL 33014-2174
Phone (305) 825-2020

Other identifiers 1

IdentifierTypeStateIssuer
057288800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624000314 FL Part B Supplier - Clinic/Group Practice 8527043397 Receives reassigned benefits from 5 practitioners
Practice locations: Miami Lakes, FL

National Provider Directory

National Provider Directory

Locations

15600 NW 67th Ave
Ste 210
Miami Lakes, FL 33014
Phone (305) 825-2020

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1497772685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 NW 67TH AVE",
            "address_2": "210",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142174",
            "telephone_number": "305-825-2020",
            "fax_number": "305-556-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 NW 67TH AVE",
            "address_2": "210",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142174",
            "telephone_number": "305-825-2020",
            "fax_number": "305-556-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI LAKES EYE CARE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "ZAMBRANO",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "305-825-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC002421",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC004209",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0047462",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0047681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057288800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.