Isabel M Carvajal OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4213 Issued in FL

Legal business name

ISABEL M CARVAJAL OD PA

Practice address

11605 Pines Blvd
Pembroke Pines, FL 33026-4109

Phone

(954) 438-2428

Fax

(954) 438-2450

NPI assigned

Jul 2, 2009

Last updated

Aug 5, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Isabel M Carvajal, OD

Title

President Optometrist

Phone

(954) 873-4130

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1649409319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 STAGECOACH DR",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732242",
            "telephone_number": "954-438-2428",
            "fax_number": "954-438-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11605 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264109",
            "telephone_number": "954-438-2428",
            "fax_number": "954-438-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISABEL M CARVAJAL OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-02",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "CARVAJAL",
        "authorized_official_first_name": "ISABEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT OPTOMETRIST",
        "authorized_official_telephone_number": "954-873-4130",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "58551",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "FL4213",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.