Jonathan David Wiebold, L.D.O.

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO 5342 Issued in FL

Practice address

706 NW 23Rd Ave
Gainesville, FL 32609-8524

Phone

(352) 367-0077

Fax

(352) 367-0079

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Adonis Optical, Inc.

  • Optician
  • Gainesville, FL
  • NPI 1265552889
  NPD (past) Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598881393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 NW 23 AVE.",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32609",
            "telephone_number": "352-367-0077",
            "fax_number": "352-367-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 NW 23RD AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326098524",
            "telephone_number": "352-367-0077",
            "fax_number": "352-367-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBOLD",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "L.D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO 5342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren Whyte, MS, RD
• Stefan C.M. Wickli, CTRS
• Carly Ann Wicksell
• Holly Widell, PHARMD
• Charles Glenn Widmer, D.D.S., M.S.
• Bret N Wiechmann, MD
• Katherine Anne Wiedenhofer, PA
• Ashley Brooke Wiegand, CCC-SLP
• Amy Wiemers
• Brenda Ann Wiens, PHD

• Optician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.