NPIMap

Organization Active NPI

Mobile Doctors of Florida PA

  • Optometrist
  • North Bay Village, FL
National Provider Identifier
1720312440
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4397 Issued in FL
Legal business name
MOBILE DOCTORS OF FLORIDA PA
Practice address
1881 79TH Street Cswy
2006
North Bay Village, FL 33141-4222
Phone
(305) 439-2015
Fax
(305) 675-0443
NPI assigned
Sep 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Dr. Jason Xuna, ODNPI 1861655409
Title
President
Phone
(305) 717-8181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPC4397 FL Primary

Addresses

Primary practice location

1881 79TH Street Cswy
2006
North Bay Village, FL 33141-4222

Mailing address

1881 79TH Street Cswy
2006
North Bay Village, FL 33141-4222
Phone (305) 717-8181

Other identifiers 1

IdentifierTypeStateIssuer
621009100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100115000850 FL Part B Supplier - Clinic/Group Practice 8527100320 Receives reassigned benefits from 11 practitioners
Practice locations: Lauderdale Lakes, FL; Miami, FL

National Provider Directory

National Provider Directory
Tax ID family
Mobile Doctors of Florida2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1720312440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 79TH STREET CSWY",
            "address_2": "2006",
            "city": "NORTH BAY VILLAGE",
            "state": "FL",
            "postal_code": "331414222",
            "telephone_number": "305-717-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 79TH STREET CSWY",
            "address_2": "2006",
            "city": "NORTH BAY VILLAGE",
            "state": "FL",
            "postal_code": "331414222",
            "telephone_number": "305-439-2015",
            "fax_number": "305-675-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DOCTORS OF FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "XUNA",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-717-8181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621009100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bay Village, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.