NPIMap

Organization Active NPI

20/20 Club

  • Optometrist
  • Royal Palm Beach, FL
National Provider Identifier
1790922813
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4365 Issued in FL
Legal business name
20/20 CLUB
Practice address
10155 Okeechobee Blvd
Optical
Royal Palm Beach, FL 33411-1404
Phone
(516) 784-2778
Fax
(561) 798-9409
NPI assigned
Jan 12, 2009
Last updated
Jan 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Dr. Michael Joe Nodland, O.D.NPI 1639328750
Title
Manager
Phone
(561) 784-2778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4365 FL Primary

Addresses

Primary practice location

10155 Okeechobee Blvd
Optical
Royal Palm Beach, FL 33411-1404

Mailing address

10155 Okeechobee Blvd
Optical
Royal Palm Beach, FL 33411-1404
Phone (516) 784-2778

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1790922813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10155 OKEECHOBEE BLVD",
            "address_2": "OPTICAL",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111404",
            "telephone_number": "516-784-2778",
            "fax_number": "561-798-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10155 OKEECHOBEE BLVD",
            "address_2": "OPTICAL",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111404",
            "telephone_number": "516-784-2778",
            "fax_number": "561-798-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20/20 CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "NODLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-784-2778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.