Organization Active NPI

Truly Eye Care PLLC

  • Optometrist
  • Windermere, FL
National Provider Identifier
1629726906
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TRULY EYE CARE PLLC
Practice address
4750 The Grove Dr Ste 164
Windermere, FL 34786-8425
Phone
(407) 801-2477
NPI assigned
Mar 15, 2022
Last updated
Mar 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Jennifer Gonzales
Title
Owner
Phone
(407) 801-2477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

4750 The Grove Dr Ste 164
Windermere, FL 34786-8425

Mailing address

4750 The Grove Dr Ste 164
Windermere, FL 34786-8425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220611000437 FL Part B Supplier - Clinic/Group Practice 4486032919 Receives reassigned benefits from 1 practitioner
Practice locations: Windermere, FL

National Provider Directory

National Provider Directory

Locations

4750 The Grove Dr
Ste 164
Windermere, FL 34786
Phone (407) 801-2477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1629726906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 THE GROVE DR STE 164",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347868425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 THE GROVE DR STE 164",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347868425",
            "telephone_number": "407-801-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRULY EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-801-2477"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windermere, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.