Individual provider Active NPI

Shafraz Hassan, LDO

  • Optician
  • Palm Beach Gardens, FL
National Provider Identifier
1770862138
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO5111 Issued in FL
Practice address
7101 Fairway Dr
1St, Floor
Palm Beach Gardens, FL 33418-3701
Phone
(561) 355-8577
Fax
(561) 355-8584
NPI assigned
Aug 16, 2011
Last updated
Aug 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO5111 FL Primary

Addresses

Primary practice location

7101 Fairway Dr
1St, Floor
Palm Beach Gardens, FL 33418-3701

Mailing address

7101 Fairway Dr
1St, Floor
Palm Beach Gardens, FL 33418-3701
Phone (561) 355-8577

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
DO5111FLMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1770862138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 FAIRWAY DR",
            "address_2": "1ST, FLOOR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183701",
            "telephone_number": "561-355-8577",
            "fax_number": "561-355-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 FAIRWAY DR",
            "address_2": "1ST, FLOOR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183701",
            "telephone_number": "561-355-8577",
            "fax_number": "561-355-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "SHAFRAZ",
        "name_prefix": "Mr.",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO5111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.