Ryan-Quang Van, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5833 Issued in FL

Practice address

3200 S University Dr
Davie, FL 33328-2018

Phone

(954) 397-0527

NPI assigned

Jun 10, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Nova Southeastern University, Inc

  • Optometrist
  • Davie, FL
  • NPI 1588802169
  NPD
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517
  NPD (past)

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1801411392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S. UNIVERSITY DR",
            "address_2": "ZIFF BUILDING 2ND FLOOR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-397-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "RYAN-QUANG",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Mark Van Benthuysen
• Vincent Bram Van Hasselt, PH.D.
• Lauren Van Hemert
• Chad Van Horn, PA-C
• Richard Van, O.D.
• Heidi Elise Vanderbloomer, DPT
• Pradeep Vanguri, PHD, ATC
• James Brian Vann, LMHC
• Vanphil Silver Services Inc
• Crystal Varela, OD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.