Individual provider Active NPI

Lorena Miranda, OD

  • Optometrist
  • Winter Garden, FL
National Provider Identifier
1689865149
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4225 Issued in FL
Practice address
13275 W Colonial Dr
Winter Garden, FL 34787-3984
Phone
(407) 905-8827
Fax
(407) 654-4079
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4225 FL Primary

Addresses

Primary practice location

13275 W Colonial Dr
Winter Garden, FL 34787-3984

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Other practice location 1

7912 Forest City Rd
Orlando, FL 32810-2907
Phone (407) 905-8827

Other practice location 2

13275 W Colonial Dr
Winter Garden, FL 34787
Phone (407) 905-8827

Other identifiers 1

IdentifierTypeStateIssuer
621259000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081120000257 FL Practitioner - Optometry 1759470669 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc CurrentSince Mar 7, 2016 Accepting new patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc CurrentSince Mar 7, 2016 Accepting new patients
Sidney J Stern Visual Health Centers PA Optometrist PastSince Nov 1, 2005 Accepting new patients
The Nemours Foundation Past Accepting new patients
Sidney J Stern Visual Health Centers PA Optometrist Past Accepting new patients
Gulf Coast Optometry, PA PastSince Jun 1, 2010 Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

225 E 7th St
Apopka, FL 32703
Phone (407) 886-6201

7900 Forest City Rd
Orlando, FL 32810
Phone (407) 614-5337

7912 Forest City Rd
Orlando, FL 32810
Phone 4079058827 ext. 2997

840 Mercy Dr
Pine Hills, FL 32808

212 E Main St
Tavares, FL 32778
Phone (352) 314-7409

13275 W Colonial Dr
Winter Garden, FL 34787

110 S Woodland St
Winter Garden, FL 34787

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1689865149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13275 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873984",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7912 Forest City Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328102907",
            "country_code": "US",
            "telephone_number": "407-905-8827",
            "fax_number": "407-660-1667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13275 W Colonial Dr",
            "address_purpose": "LOCATION",
            "city": "Winter Garden",
            "state": "FL",
            "postal_code": "34787",
            "country_code": "US",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "LORENA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621259000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.