Individual provider Active NPI

Whitney Roberson Miranda, O.D.

  • Optometrist
  • Kissimmee, FL
National Provider Identifier
1508264193
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC005014 Issued in FL
Practice address
2376 E Irlo Bronson Memorial Hwy
Kissimmee, FL 34744-5401
Phone
(407) 847-0057
Fax
(407) 518-0003
NPI assigned
Dec 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5014 FL
Corneal and Contact Management Optometrist 152WC0802X OPC005014 FL
Pediatric Optometrist 152WP0200X OPC005014 FL
Vision Therapy Optometrist 152WV0400X OPC005014 FL
Optometrist 152W00000X OPC005014 FL Primary

Addresses

Primary practice location

2376 E Irlo Bronson Memorial Hwy
Kissimmee, FL 34744-5401

Mailing address

PO Box 207151
Dallas, TX 75320-7151
Phone (636) 200-4393

Other practice location 1

1495 W State Road 434 Ste 109
Longwood, FL 32750-3861
Phone (407) 332-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210304000955 FL Practitioner - Optometry 7618383340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sight and Sun Eyeworks LLCGroup PAC ID 0042362527, 27 clinicians

Practice addresses (Care Compare)

2376 E Irlo Bronson Memorial Hwy
Kissimmee, FL 34744-5401
Phone (407) 847-0057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC5014FLMDOptometrist
OPC005014FLMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sight and Sun Eyeworks LLC Optometrist CurrentSince Mar 2, 2021 Accepting new patients
Sight and Sun Eyeworks LLC Optometrist CurrentSince Mar 2, 2021 Accepting new patients
Steven J Zorn OD PA Optometrist Past Accepting new patients
Marc H Sherman OD PA Optometrist PastSince Dec 13, 2022 Accepting new patients

Locations

2376 E Irlo Bronson Memorial Hwy
Kissimmee, FL 34744
Phone (407) 847-0057

1308 W Nine Mile Rd
Ste 1112
Pensacola, FL 32534
Phone (850) 479-2020

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: whitneymiranda@direct.eyecare-partners.com

Organizations & group practices 4

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": "1418342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1508264193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207151",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207151",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 E IRLO BRONSON MEMORIAL HWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445401",
            "telephone_number": "407-847-0057",
            "fax_number": "407-518-0003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1495 W State Road 434 Ste 109",
            "address_purpose": "LOCATION",
            "city": "Longwood",
            "state": "FL",
            "postal_code": "327503861",
            "country_code": "US",
            "telephone_number": "407-332-8255",
            "fax_number": "407-332-5769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "WHITNEY",
        "middle_name": "ROBERSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-12",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5014",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC005014",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "FL",
            "license": "OPC005014",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "FL",
            "license": "OPC005014",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC005014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.