Retina Macula Specialists PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME85244 Issued in FL

Legal business name

RETINA MACULA SPECIALISTS PLLC

Practice address

720 W Oak St
Suite 301
Kissimmee, FL 34741-4989

Phone

(407) 931-1510

Fax

(407) 931-3759

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Jaime H Membreno, MDNPI 1255309704

Title

President

Phone

(407) 931-1510

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Retina Macula Specialist2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Retina Macula Specialists PLLC

  • Specialist
  • Kissimmee, FL
  • NPI 1134304884
  NPD tax ID

Locations

Practitioners 2

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

• Jaime Humberto Membreno, MD

  • Retina Specialist (Ophthalmology) Physician
  • Kissimmee, FL
  • NPI 1255309704
  Medicare reassignment NPD Authorized official
• Lisa H Choo, M.D.

  • Ophthalmology Physician
  • Orlando, FL
  • NPI 1790716942
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1528112950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W OAK ST",
            "address_2": "SUITE 301",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414989",
            "telephone_number": "407-931-1510",
            "fax_number": "407-931-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W OAK ST",
            "address_2": "SUITE 301",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414989",
            "telephone_number": "407-931-1510",
            "fax_number": "407-931-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA MACULA SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "MEMBRENO",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-931-1510",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME85244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Ressy, ARNP
• Zoelly Resto Betancourt
• Yurisan Yoe Resto
• Christian D Restrepo, MD
• Retina Macula Specialists PLLC
• Genesis Reveron Fonseca
• Revitalize Medical & Aesthetic Wellness Center LLC
• Revitalizing Infusion Therapies, LLC
• Revitalizing Lifestyle Medicine LLC
• Diane Rey

• Ophthalmology Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.