NPIMap

Organization Active NPI

Cape Coral Eye Center, P.a.

  • Optometrist
  • Cape Coral, FL
National Provider Identifier
1700911161
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3656 Issued in FL
Legal business name
CAPE CORAL EYE CENTER, P.A.
Practice address
900 SW Pine Island Rd
Suite 120
Cape Coral, FL 33991-1979
Phone
(239) 542-2020
Fax
(239) 242-9953
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Authorized official

Name
Dr. Jennifer Gallo, O.D.
Title
Optometrist
Phone
(239) 542-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC3656 FL Primary

Addresses

Primary practice location

900 SW Pine Island Rd
Suite 120
Cape Coral, FL 33991-1979

Mailing address

PO Box 101427
Cape Coral, FL 33910-1427
Phone (239) 540-8718

Other identifiers 1

IdentifierTypeStateIssuer
620840100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Eye Surgery Laser Cen10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

900 SW Pine Island Rd
Ste 120
Cape Coral, FL 33991

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1700911161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101427",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339101427",
            "telephone_number": "239-540-8718",
            "fax_number": "239-945-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SW PINE ISLAND RD",
            "address_2": "SUITE 120",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339911979",
            "telephone_number": "239-542-2020",
            "fax_number": "239-242-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE CORAL EYE CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "GALLO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "239-542-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620840100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.