Individual provider Active NPI

Gabriela Mota, LDO

  • Optician
  • Kissimmee, FL
National Provider Identifier
1548074479
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO7618 Issued in FL
Practice address
104 W Vine St
Kissimmee, FL 34741-4430
Phone
(347) 471-9024
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO7618 FL Primary

Addresses

Primary practice location

104 W Vine St
Kissimmee, FL 34741-4430

Mailing address

2574 Tanner Ter
Kissimmee, FL 34743-6118
Phone (347) 471-9024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DO7618FLMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1548074479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2574 TANNER TER",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347436118",
            "telephone_number": "347-471-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W VINE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414430",
            "telephone_number": "347-471-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTA",
        "first_name": "GABRIELA",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO7618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.