Individual provider Active NPI

Denise Lynn Mezquia, O.D.

  • Optometrist
  • Orlando, FL
National Provider Identifier
1710408992
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5483 Issued in FL
Practice address
1800 Pembrook Dr Ste 120
Orlando, FL 32810
Phone
(407) 586-7992
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X T008563 NY
Optometrist 152W00000X OPC5483 FL Primary

Addresses

Primary practice location

1800 Pembrook Dr Ste 120
Orlando, FL 32810

Mailing address

13400 Highland Woods Dr
Clermont, FL 34711-8536
Phone (786) 385-2708

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

State licenses

LicenseStateTypeSpecialty
OPC5483FLMDOptometrist
T008563NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1710408992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 HIGHLAND WOODS DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118536",
            "telephone_number": "786-385-2708",
            "fax_number": "518-599-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 PEMBROOK DR STE 120",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32810",
            "telephone_number": "407-586-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZQUIA",
        "first_name": "DENISE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T008563",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.