Active NPI
Brian Pall, OD
- Optometrist
- Jacksonville, FL
National Provider Identifier
1861108706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC3607
- Practice address
- 7500 Centurion Pkwy Ste 100
Jacksonville, FL 32256-0517 - Phone
- (904) 629-2289
- NPI assigned
- Jan 24, 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC3607 | FL | Primary |
Addresses
Primary practice location
7500 Centurion Pkwy Ste 100
Jacksonville, FL 32256-0517
Mailing address
3878 Dylan CT
Jacksonville, FL 32223-2707
Phone (904) 629-2289
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 |
|---|---|---|---|
| OPC3607 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1861108706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3878 DYLAN CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322232707",
"telephone_number": "904-629-2289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7500 CENTURION PKWY STE 100",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560517",
"telephone_number": "904-629-2289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALL",
"first_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-24",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC3607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
- William Taylor Palfrey Jr., MD
- Kelsey Palhegyi, PA-C
- Stefanie Paliatsos, PH.D.
- Len Quimzon Palis, APRN
- Shreela Palit
- Patricia Jo Pallay, LMHC
- Palm Beach Pediatrics, LLC (Bluebird Kids Health)
- Palm Beach Pediatrics, LLC (Bluebird Kids Health)
- Palm Beach Pediatrics, LLC (Bluebird Kids Health)
- Palm Garden of Jacksonville LLC (Palm Garden of Jacksonville)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.