Bethany L Bremer OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2606 Issued in FL

Legal business name

BETHANY L BREMER OD LLC

Practice address

101 N. Congress Ave
Lake Park, FL 33403

Phone

(561) 881-8006

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bethany L. BremerNPI 1720153505

Title

Owner

Phone

(561) 881-8006

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bethany L. Bremer, O.D.

  • Optometrist
  • Lake Park, FL
  • NPI 1720153505
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1790907202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N CONGRESS AVE",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334033804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N. CONGRESS AVE",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "33403",
            "telephone_number": "561-881-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY L BREMER OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "BREMER",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-881-8006",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621230100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rosa Mari Bassett, PHARMD
• Lynne Beaumont, PT
• Marimer Beltran Nunez, PHARMD
• Kristin Brave
• Bethany L. Bremer, O.D.
• Kristopher Brown, CF LVL 1, USAW COACH
• Xavier Deon Bryant Jr., RN
• Robert W Buck, TPM

• Optometrist in Lake Park, FL
• Providers in Lake Park, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.