Organization Active NPI

Kathryn a Estevez OD LLC

  • Optometrist
  • Davie, FL
National Provider Identifier
1689145419
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KATHRYN A ESTEVEZ OD LLC
Practice address
6795 Stirling Rd
Davie, FL 33314-7118
Phone
(954) 961-1509
Fax
(954) 961-1604
NPI assigned
Dec 5, 2018
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Kathryn Alvaro-Estevez, OD
Title
Owner
Phone
(954) 961-1509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

6795 Stirling Rd
Davie, FL 33314-7118

Mailing address

6795 Stirling Rd
Davie, FL 33314-7118
Phone (954) 961-1509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191227001112 FL Part B Supplier - Clinic/Group Practice 5698109650 Receives reassigned benefits from 1 practitioner
Practice locations: Davie, FL

National Provider Directory

National Provider Directory

Locations

6795 Stirling Rd
Davie, FL 33314
Phone (954) 961-1509

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1689145419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6795 STIRLING RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147118",
            "telephone_number": "954-961-1509",
            "fax_number": "954-961-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6795 STIRLING RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147118",
            "telephone_number": "954-961-1509",
            "fax_number": "954-961-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRYN A ESTEVEZ OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-05",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "ALVARO-ESTEVEZ",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-961-1509",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.