Individual provider Active NPI

Lucy Jeanette Benard-Zeledon, O.D.

  • Optometrist
  • Homestead, FL
National Provider Identifier
1639295371
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3685 Issued in FL
Practice address
13600 SW 288TH St
Homestead, FL 33033
Phone
(305) 248-8883
Fax
(844) 814-2970
NPI assigned
Mar 22, 2007
Last updated
May 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3685 FL Primary

Addresses

Primary practice location

13600 SW 288TH St
Homestead, FL 33033

Mailing address

14974 SW 11TH St
Miami, FL 33194-2505
Phone (786) 999-4205

Other practice location 1

17650 NW 2nd Ave
Adjacent to Walmart Vision Center
Miami, FL 33169-5019
Phone (305) 249-2505

Other identifiers 2

IdentifierTypeStateIssuer
620785501MedicaidFL
620785500MedicaidFL

Other names 1

  • Lucy Jeanette Benard Former name

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

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, 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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1639295371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14974 SW 11TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331942505",
            "telephone_number": "786-999-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13600 SW 288TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "33033",
            "telephone_number": "305-248-8883",
            "fax_number": "844-814-2970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17650 NW 2nd Ave",
            "address_2": "Adjacent to Walmart Vision Center",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331695019",
            "country_code": "US",
            "telephone_number": "305-249-2505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENARD-ZELEDON",
        "first_name": "LUCY",
        "middle_name": "JEANETTE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620785501",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620785500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCY",
            "last_name": "BENARD",
            "middle_name": "JEANETTE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.