Individual provider Active NPI

Sandra Mauro, O.D.

  • Optometrist
  • Orlando, FL
National Provider Identifier
1700976545
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3630 Issued in FL
Practice address
5381 Hoffner Ave
Orlando, FL 32812-2436
Phone
(407) 230-7436
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3630 FL Primary

Addresses

Primary practice location

5381 Hoffner Ave
Orlando, FL 32812-2436

Mailing address

5381 Hoffner Ave
Orlando, FL 32812-2436
Phone (407) 230-7436

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
I20140924000187 FL Practitioner - Optometry 6507824828 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3630FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra Mauro OD, PA Optometrist CurrentSince Sep 4, 2014 Accepting new patients
Lonestar Vision Center of San Antonio, LLC Optometrist Past Accepting new patients

Locations

5381 Hoffner Ave
Orlando, FL 32812
Phone (407) 230-7436

Organizations & group practices 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1700976545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5381 HOFFNER AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328122436",
            "telephone_number": "407-230-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5381 HOFFNER AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328122436",
            "telephone_number": "407-230-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURO",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.