Paul A. Breault, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OPC 3216 Issued in FL

Practice address

1647 Sun City Center PLZ Ste 103
Sun City Center, FL 33573-5374

Phone

(813) 634-6344

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Optometric Associates of Florida, P.a.

  • Optometrist
  • Largo, FL
  • NPI 1346316676
  NPD (past)
• Sun Hill Optical Inc

  • Optometrist
  • Sun City Center, FL
  • NPI 1225157415
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1770517740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 SUN CITY CENTER PLZ STE 103",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335735374",
            "telephone_number": "813-634-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 SUN CITY CENTER PLZ STE 103",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335735374",
            "telephone_number": "813-634-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAULT",
        "first_name": "PAUL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3216",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC 3216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX-ID #",
            "identifier": "59-3632508",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Apex",
            "affiliation": "N",
            "address_1": "1647 Sun City Center Plz Ste 103",
            "city": "Sun City Center",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335735374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael James Boully Jr., P.T.
• Christina Bowens, APRN
• Angelita Bowers
• Sarah Bowers, OT, CHT
• Brandon Eye Associates PA
• Lisa Brewer
• Cameron Brooks
• Brown Staffing Solutions LLC
• Kelsey A Bryant, PT, DPT
• Jocelyn D Bueno, M.D.

• Corneal and Contact Management Optometrist in Sun City Center, FL
• Providers in Sun City Center, FL by specialty
• Corneal and Contact Management Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.