Individual provider Active NPI

Flora Chen Poveda, O.D.

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1770625899
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC003643 Issued in FL
Practice address
11111 San Jose Blvd Ste 44
Jacksonville, FL 32223-7274
Phone
(904) 292-3976
Fax
(904) 292-5322
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC003643 FL Primary

Addresses

Primary practice location

11111 San Jose Blvd Ste 44
Jacksonville, FL 32223-7274

Mailing address

11111 San Jose Blvd Ste 44
Jacksonville, FL 32223-7274
Phone (904) 292-3976

Other names 1

  • Dr. Flora Chen Former name

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
I20141120001715 FL Practitioner - Optometry 7012139330 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC003643FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary M Futch OD PA Optometrist CurrentSince Nov 12, 2016 Accepting new patients
Gulf Coast Optometry, PA CurrentSince Jun 5, 2020 Accepting new patients
Mandarin Eyecare Assoc, Inc Past Accepting new patients
National Vision, Inc. Past Accepting new patients
Samuel Hathy III,O.D. Past Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

13534 Beach Blvd
#3
Jacksonville, FL 32224
Phone (904) 383-3400

14021 Lunar Dr
Unit 1
Jacksonville, FL 32218
Phone (904) 351-0057

31 S 6th St
Macclenny, FL 32063
Phone (904) 259-6259

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

Organizations & group practices 6

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1770625899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111 SAN JOSE BLVD STE 44",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237274",
            "telephone_number": "904-292-3976",
            "fax_number": "904-292-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 SAN JOSE BLVD STE 44",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237274",
            "telephone_number": "904-292-3976",
            "fax_number": "904-292-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POVEDA",
        "first_name": "FLORA",
        "middle_name": "CHEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC003643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FLORA",
            "last_name": "CHEN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.