Gillian A. Thomas-Burke, O.D.
Individual provider Active NPI Optometrist · Kendall, FL
NPI 1821155466 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821155466
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPC2817 (FL)
- Practice address
- 12640 N. Kendall Dr.
Kendall, FL 33186 - Phone
- (305) 273-7790
- Fax
- (305) 273-8018
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211105000148 | FL | Practitioner - Optometry | 3173912599 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC2817 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Florida Vision Services, Inc. | Optometrist | Current |
Accepting new patients |
Locations
2900 W Cypress Creek Rd
Ste 4
Ft Lauderdale, FL 33309
Phone (954) 676-8446
12550 Pines Blvd
Pembroke Pines, FL 33027
Phone (954) 430-4030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC2817 | FL | Yes |
Addresses
Primary practice location
12640 N. Kendall Dr.
Kendall, FL 33186
Mailing address
12640 N. Kendall Dr.
Kendall, FL 33186
Phone (305) 273-7790
Other providers in Kendall, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.