Active NPI
Muktiar Idrees
- Optician
- Plantation, FL
National Provider Identifier
1679163810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Practice address
- 1860 N Pine Island Rd Ste 105
Plantation, FL 33322-5234 - Phone
- (754) 216-8333
- NPI assigned
- Jan 21, 2021
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
1860 N Pine Island Rd Ste 105
Plantation, FL 33322-5234
Mailing address
1860 N Pine Island Rd Ste 105
Plantation, FL 33322-5234
Phone (754) 216-8333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108026100 | Medicaid | FL |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1679163810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 N PINE ISLAND RD STE 105",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333225234",
"telephone_number": "754-216-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1860 N PINE ISLAND RD STE 105",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333225234",
"telephone_number": "754-216-8333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IDREES",
"first_name": "MUKTIAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108026100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.