Individual provider Active NPI

Amanda M Sanford, O.D.

  • Optometrist
  • Plantation, FL
National Provider Identifier
1801102280
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5347 Issued in FL
Practice address
12331 SW 3Rd St Ste 300
Plantation, FL 33325-2815
Phone
(954) 908-3937
Fax
(954) 903-4176
NPI assigned
Aug 24, 2010
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5347 FL Primary

Addresses

Primary practice location

12331 SW 3Rd St Ste 300
Plantation, FL 33325-2815

Mailing address

12331 SW 3Rd St Ste 300
Plantation, FL 33325-2815
Phone (954) 908-3937

Other practice location 1

1005 W Sugarland Hwy
Clewiston, FL 33440-2706
Phone (863) 902-9844

Other identifiers 1

IdentifierTypeStateIssuer
114222800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110414000675 NY Practitioner - Optometry 0648454751 Reassigns benefits to 1 organization
I20210406001158 FL Practitioner - Optometry 0648454751 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12331 SW 3Rd St
Plantation, FL 33325-2818
Phone (605) 690-8580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Sanford OD LLC Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Gulf Coast Optometry, PA CurrentSince Mar 31, 2021 Accepting new patients
DRS. Cukierman & Gomez, Inc Optometrist CurrentSince Jan 10, 2024 Accepting new patients
Shari L. Gustin OD, PC Optometrist CurrentSince Mar 9, 2015 Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision, Inc. Past Accepting new patients
The Cataract Vision Institute LLC 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

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

246 S Flamingo Rd
Pembroke Pines, FL 33027
Phone (954) 442-4602

12331 SW 3rd St
Plantation, FL 33325
Phone (605) 690-8580

12331 SW 3rd St
Ste 300
Plantation, FL 33325
Phone (605) 690-8580

2241 Tamiami Trl
Port Charlotte, FL 33948
Phone (941) 629-9309

1725 W Mlk Blvd
Tampa, FL 33607
Phone (239) 800-1717

81 E Main St
Webster, NY 14580
Phone (585) 265-3710

Networks

  • Freedom Health HMO Network

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1801102280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12331 SW 3RD ST STE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333252815",
            "telephone_number": "954-908-3937",
            "fax_number": "954-903-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12331 SW 3RD ST STE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333252815",
            "telephone_number": "954-908-3937",
            "fax_number": "954-903-4176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 W Sugarland Hwy",
            "address_purpose": "LOCATION",
            "city": "Clewiston",
            "state": "FL",
            "postal_code": "334402706",
            "country_code": "US",
            "telephone_number": "863-902-9844",
            "fax_number": "954-902-4176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "AMANDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114222800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.