Individual provider Active NPI

Ana Ruth Quintero, O.D.

  • Optometrist
  • Brandon, FL
National Provider Identifier
1831222017
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3933 Issued in FL
Practice address
1180 Nikki View Dr
Lake Brandon Professional Park
Brandon, FL 33511-4868
Phone
(813) 651-1400
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3933 FL Primary

Addresses

Primary practice location

1180 Nikki View Dr
Lake Brandon Professional Park
Brandon, FL 33511-4868

Mailing address

1180 Nikki View Dr
Lake Brandon Professional Park
Brandon, FL 33511-4868
Phone (813) 651-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141106002034 FL Practitioner - Optometry 6507088523 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3933FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Value Vision of Tampa Bay Inc Optometrist CurrentSince Sep 3, 2014 Accepting new patients

Locations

1180 Nikki View Dr
Brandon, FL 33511
Phone (813) 651-1400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1831222017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 NIKKI VIEW DR",
            "address_2": "LAKE BRANDON PROFESSIONAL PARK",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114868",
            "telephone_number": "813-651-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 NIKKI VIEW DR",
            "address_2": "LAKE BRANDON PROFESSIONAL PARK",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114868",
            "telephone_number": "813-651-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "ANA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.