Michael Pennachio, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME45426 Issued in FL

Legal business name

MICHAEL PENNACHIO, LLC

Practice address

1100 S Grove St
Eustis, FL 32726-5524

Phone

(352) 227-1999

NPI assigned

Feb 19, 2018

Last updated

Feb 19, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

MICHAEL PENNACHIO, LLCAs reported in NPPES

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

Authorized official

Name

Michael Pennachio, MDNPI 1750312005

Title

Owner

Phone

(352) 227-1999

Specialties & licenses 1

Addresses

Other names 1

• Michael Pennachio, LLC Other name

Part of

Michael Pennachio LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Michael Pennachio, LLC

  • Ophthalmology Physician
  • Clermont, FL
  • NPI 1477092187
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Pennachio, M.D.

  • Ophthalmology Physician
  • Leesburg, FL
  • NPI 1750312005
  NPD Authorized official

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1730689530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14244 SR 50",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118003",
            "telephone_number": "352-227-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S GROVE ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327265524",
            "telephone_number": "352-227-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL PENNACHIO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHAEL PENNACHIO, LLC",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "PENNACHIO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-227-1999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME45426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Pennachio, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Vernon Dale Meeks, D.M.D.
• Rosarlem S Mejias, ARNP
• Jean Ricot Merissaint
• Terri Anne Meyer, LMHC
• MF Lake Eustis LLC (Lake Eustis Health and Rehabilitation Center)
• Mid-Florida Pathology LLC
• Mid-Florida Pulmonary Associates PA
• Erin Milburn
• Lauren Miller, SLPA
• Devin Moberg

• Ophthalmology Physician in Eustis, FL
• Providers in Eustis, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.