Michael O. Broder, OD, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP0002949 Issued in FL

Legal business name

MICHAEL O. BRODER, OD, PA

Practice address

2165 Tamiami TRL S
Venice, FL 34293-5034

Phone

(941) 493-8787

Fax

(941) 408-8446

NPI assigned

Oct 15, 2010

Last updated

Oct 27, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jane Ellen Barton

Title

Receptionist

Phone

(941) 493-8787

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1770893471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935034",
            "telephone_number": "941-493-8787",
            "fax_number": "941-408-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935034",
            "telephone_number": "941-493-8787",
            "fax_number": "941-408-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL O. BRODER, OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "941-493-8787",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP0002949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Metrolina Infectious Diseases, P.a.
• Stephen Metz
• MG Venice Subtenant LLC (Truewood by Merrill, Venice)
• MHC Area 8, LLC (Choice Health at Home)
• Michael Mercandetti MD PA
• Michael T. McCormick & Associates PA
• Michael T. McCormick & Associates PA
• Michael W. Kemplin, MD, PA
• Jennifer Michalak
• Luc Michiels, P.T.

• Optometrist in Venice, FL
• Providers in Venice, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.