Active NPI
Juan Carlos Moreno, LDO
- Optician
- Tampa, FL
National Provider Identifier
1841065216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO7235
- Practice address
- 15302 N Nebraska Ave
Tampa, FL 33613-1448 - Phone
- (813) 371-9020
- Fax
- (813) 971-2621
- NPI assigned
- Nov 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO7235 | FL | Primary |
Addresses
Primary practice location
15302 N Nebraska Ave
Tampa, FL 33613-1448
Mailing address
8408 Seven Coves CT
Tampa, FL 33634-1041
Phone (813) 492-9381
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO7235 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700092800000",
"number": "1841065216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8408 SEVEN COVES CT",
"city": "TAMPA",
"state": "FL",
"postal_code": "336341041",
"telephone_number": "813-492-9381",
"fax_number": "813-971-2621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15302 N NEBRASKA AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336131448",
"telephone_number": "813-371-9020",
"fax_number": "813-971-2621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "JUAN",
"middle_name": "CARLOS",
"credential": "LDO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-16",
"last_updated": "2023-11-16",
"certification_date": "2023-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO7235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.