John A. Dziadul Jr., OD

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

OPC 2258 Issued in FL

Practice address

2900 Veterans Way
Viera, FL 32940-8007

Phone

(321) 637-3788

Fax

(321) 637-3509

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eyewearllc

  • Eyewear Supplier
  • Melbourne, FL
  • NPI 1518054956
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1508807595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 ARCO CORPORATE DR STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276172042",
            "telephone_number": "919-286-5237",
            "fax_number": "919-286-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3788",
            "fax_number": "321-637-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIADUL",
        "first_name": "JOHN",
        "middle_name": "A.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2258",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "FL",
            "license": "OPC 2258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Faust Duke Jr., O.D.
• Delbert Ernest Duncklee Jr., LCSW
• Brandi Tashiana Durkins, LCSW
• Murray Dweck, MD
• Laura Dyer
• Elite Concierge Care Management
• George Elkomos, M.D.
• Maria Estribi
• John Adam Evelyn, LCSW
• Eyecare Associates of Viera

• Low Vision Rehabilitation Optometrist in Viera, FL
• Providers in Viera, FL by specialty
• Low Vision Rehabilitation Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.