NPIMap

Organization Active NPI

Diferdinando & Diferdinando PA

  • Optometrist
  • Deland, FL
National Provider Identifier
1801908686
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC001527 Issued in FL
Legal business name
DIFERDINANDO & DIFERDINANDO PA
Practice address
2659 S Woodland Blvd
Deland, FL 32720-8601
Phone
(386) 736-3579
Fax
(386) 736-6447
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Authorized official

Name
Dr. George O Diferdinando, O.D.NPI 1962528901
Title
President
Phone
(386) 736-3579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC001527 FL Primary

Addresses

Primary practice location

2659 S Woodland Blvd
Deland, FL 32720-8601

Mailing address

2659 S Woodland Blvd
Deland, FL 32720-8601
Phone (386) 736-3579

Other identifiers 2

IdentifierTypeStateIssuer
078190800MedicaidFL
078632200MedicaidFL

National Provider Directory

National Provider Directory

Locations

2659 S Woodland Blvd
Ste A
Deland, FL 32720

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1801908686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2659 S WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327208601",
            "telephone_number": "386-736-3579",
            "fax_number": "386-736-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 S WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327208601",
            "telephone_number": "386-736-3579",
            "fax_number": "386-736-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIFERDINANDO & DIFERDINANDO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "DIFERDINANDO",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-736-3579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078190800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078632200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.