Coastal Clear Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

COASTAL CLEAR EYECARE

Practice address

155 Fountains Way Unit 11
Saint Johns, FL 32259-1143

Phone

(404) 932-2802

NPI assigned

Jul 7, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Romanda Demetrios, OD

Title

Owner/Ceo

Phone

(404) 932-2802

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Romanda Basaly Demetrios, O.D.

  • Optometrist
  • Saint Johns, FL
  • NPI 1003243502

  FL, Optometrist

  Medicare reassignment NPD

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1831822899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 RUM RUNNER WAY",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322592267",
            "telephone_number": "404-932-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 FOUNTAINS WAY UNIT 11",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322591143",
            "telephone_number": "404-932-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CLEAR EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "DEMETRIOS",
        "authorized_official_first_name": "ROMANDA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "404-932-2802",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Gerard Chiafair, DDS
• Children'S Express Care Clinic
• Ann Allisa Church, MD
• Eiryn Cintron-Baerga, PA-C
• Makayla N Clemons
• Kimberly Ann Coggins, PA-C
• Daniel Collins
• Angela Damon Colon, RN
• Kevin Munish Comar, MD
• Comfortable Care Dental Health Professionals, P.a.

• All providers in Saint Johns, FL
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.