Active NPI
Richard S Miller, OD
- Optometrist
- Lake Wales, FL
National Provider Identifier
1649381708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC001041
- Practice address
- 2000 Sr 60 East
Lake Wales, FL 33898-5182 - Phone
- (863) 679-1915
- Fax
- (863) 679-1634
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC001041 | FL | Primary |
Addresses
Primary practice location
2000 Sr 60 East
Lake Wales, FL 33898-5182
Mailing address
2000 Sr 60 East
Lake Wales, FL 33898-5182
Phone (863) 676-6076
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1041 | FL | MD | Mental Health Counselor |
| OPC001041 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649381708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 SR 60 EAST",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338985182",
"telephone_number": "863-676-6076",
"fax_number": "863-679-1634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 SR 60 EAST",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338985182",
"telephone_number": "863-679-1915",
"fax_number": "863-679-1634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "RICHARD",
"middle_name": "S",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC001041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Wales, FL
Sources for this page
- 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.