Individual provider Active NPI

Pravina P Patel, O.D.

  • Optometrist
  • Davie, FL
National Provider Identifier
1578870002
Registry record updated Sep 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4571 Issued in FL
Practice address
3200 S University Dr
Terry Building Suite 1408
Davie, FL 33328-2018
Phone
(954) 262-1402
Fax
(954) 262-1818
NPI assigned
Sep 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4571 FL Primary

Addresses

Primary practice location

3200 S University Dr
Terry Building Suite 1408
Davie, FL 33328-2018

Mailing address

711 N Pine Island Rd
Unit 304
Plantation, FL 33324-1300
Phone (352) 256-4782

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4571FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Eye Group, P.a. Optometrist PastSince Oct 1, 2006 Accepting new patients

Organizations & group practices 1

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": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1578870002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N PINE ISLAND RD",
            "address_2": "UNIT 304",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241300",
            "telephone_number": "352-256-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "TERRY BUILDING SUITE 1408",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1402",
            "fax_number": "954-262-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRAVINA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; 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.