20-20 Vision Place Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2667 Issued in FL

Legal business name

20-20 VISION PLACE INC

Practice address

12801 W Sunrise Blvd
Ste 931
Sunrise, FL 33323-4020

Phone

(954) 851-9949

NPI assigned

Mar 22, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ralph Bourjolly, ODNPI 1548390495

Title

Owner

Phone

(954) 851-9949

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ralph Bourjolly, O.D.

  • Optometrist
  • Pompano Beach, FL
  • NPI 1548390495
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1639445703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 WESTON RD",
            "address_2": "APT 248",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261111",
            "telephone_number": "561-212-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 W SUNRISE BLVD",
            "address_2": "STE 931",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333234020",
            "telephone_number": "954-851-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20-20 VISION PLACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "BOURJOLLY",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-851-9949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.