Individual provider Active NPI

Randy Grover, O.D.

  • Optometrist
  • Hialeah Gardens, FL
National Provider Identifier
1871564575
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3543 Issued in FL
Practice address
9300 NW 77TH Ave
Hialeah Gardens, FL 33140
Phone
(305) 828-8393
NPI assigned
Jan 30, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 3543 FL Primary

Addresses

Primary practice location

9300 NW 77TH Ave
Hialeah Gardens, FL 33140

Mailing address

5700 Collins Ave
#11-H
Miami Beach, FL 33140

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
I20060420000227 FL Practitioner - Optometry 8022027051 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3543FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
California Club Medical Center LLC Past Accepting new patients
Qualcare Medical Centers LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1871564575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 COLLINS AVE",
            "address_2": "#11-H",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "33140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 NW 77TH AVE",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "33140",
            "telephone_number": "305-828-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah Gardens, FL

Sources for this page

Verify at the official NPI Registry.