Elliott Optical Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO676 Issued in FL

Legal business name

ELLIOTT OPTICAL INC.

Practice address

561 Dal Hall Blvd
Lake Placid, FL 33852-5446

Phone

(863) 465-1777

Fax

(863) 465-5279

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Paul Elliott

Title

President

Phone

(863) 465-1777

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1508039256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 DAL HALL BLVD",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338525446",
            "telephone_number": "863-465-1777",
            "fax_number": "863-465-5279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 DAL HALL BLVD",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338525446",
            "telephone_number": "863-465-1777",
            "fax_number": "863-465-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOTT OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-465-1777"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela S Dolber, DPM
• Mark Doskocz, PTA
• Cassandra Catherine Dunn Morales, APRN
• Scott Earley, LMHC
• Janelle Edwards
• Emcare Physician Providers, Inc.
• Evaristo E. Rivero
• Family Medical Group PA
• Javier Leandro Fernandez, PT
• Carly Delbert Fioramanti, APRN

• All providers in Lake Placid, FL
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.