Individual provider Active NPI

William Rafael Roberts, O.D.

  • Optometrist
  • Kissimmee, FL
National Provider Identifier
1619327905
Registry record updated Sep 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5191 Issued in FL
Practice address
1204 N John Young Pkwy
Kissimmee, FL 34741-4206
Phone
(407) 933-0082
NPI assigned
Jun 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5191 FL Primary

Addresses

Primary practice location

1204 N John Young Pkwy
Kissimmee, FL 34741-4206

Mailing address

8 Birch Ave
Shalimar, FL 32579-1157
Phone (850) 218-6527

Other practice location 1

1303 E Vine St
Kissimmee, FL 34744-3642
Phone (407) 870-2020

Other practice location 2

5533 SW 64th St
Gainesville, FL 32608-9608
Phone (352) 271-5967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170613001872 FL Practitioner - Optometry 2769750827 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Doctors Optical Outlets PA Optometrist Current Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Aug 1, 2017 Accepting new patients
Gulf Coast Optometry, PA CurrentSince Oct 7, 2017 Accepting new patients
Eye Deal Optical LLC Optometrist CurrentSince Dec 31, 2025 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Aug 1, 2017 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Jul 31, 2017 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Jul 31, 2017 Accepting new patients
Jimmy Nguyen OD PA Optometrist PastSince Sep 14, 2025 Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

1303 E Vine St
Kissimmee, FL 34744
Phone (407) 870-2002

104 W Vine St
#C
Kissimmee, FL 34741
Phone (407) 944-4240

1204 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 408-5177

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Networks

  • Freedom Health HMO Network

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1619327905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BIRCH AVE",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325791157",
            "telephone_number": "850-218-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414206",
            "telephone_number": "407-933-0082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 E Vine St",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347443642",
            "country_code": "US",
            "telephone_number": "407-870-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5533 SW 64th St",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326089608",
            "country_code": "US",
            "telephone_number": "352-271-5967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "WILLIAM",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.