Ryan Nicholas OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

RYAN NICHOLAS OD LLC

Practice address

4200 Conroy Rd # B166
Orlando, FL 32839-2400

Phone

(407) 473-3539

Fax

(407) 796-8602

NPI assigned

Nov 2, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Nicholas, OD

Title

Optometrist

Phone

(909) 542-5208

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1572652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572652800000",
    "number": "1558905588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5268 BASKIN ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146920",
            "telephone_number": "909-542-5208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 CONROY RD # B166",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328392400",
            "telephone_number": "407-473-3539",
            "fax_number": "407-796-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN NICHOLAS OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-02",
        "last_updated": "2019-11-02",
        "status": "A",
        "authorized_official_last_name": "NICHOLAS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "909-542-5208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Orlando, FL
• Providers in Orlando, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.